Pathophysiology of hepatic insufficiency

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The liver is a unique and complex functioning organ, which is central in the metabolism of proteins, carbohydrates, fats and plays an important role in digestion, hematopoiesis, hemocoagulation, and detoxification processes. The pathology of the liver is complex and diverse, often accompanied by the pathology of other organs. Liver diseases are often encountered by doctors of various specialties, and for the clinician, knowledge of this pathology of this organ is essential. Currently, there is a steady increase in the number of patients with liver diseases, mostly people of working age. The development of acute and chronic liver pathology in the vast majority of cases is accompanied by the occurrence of various complications, up to the appearance of liver failure.

The lecture contains up-to-date information about the etiology and pathogenesis of hepatic pathology. Pathological processes in the liver are considered taking into account the complexity of its structural and functional organization. The main symptoms and syndromes of liver pathology are described, their pathophysiological assessment is given. Modern classifications of jaundice, hepatitis, liver failurea regiven.

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About the authors

Tatyana V. Brus

St. Petersburg State Pediatric Medical University

Author for correspondence.

PhD, MD, Associate Professor of the Department of Pathological Physiology with a Class of Immunopathology

Russian Federation, Saint Petersburg

Vladimir A. Evgrafov

St. Petersburg State Pediatric Medical University


PhD, MD, Associate Professor of the Department, of Anesthesiology, Resuscitation and Emergency Pediatrics

Russian Federation, Saint Petersburg


  1. Brus TV, Pyurveev SS, Kravtsova AA, Balashov LD. Sravnitel’naya kharakteristika modelei zhirovoi distrofii pecheni razlichnogo geneza. Children’s Medicine of North-West. 2021;9(1):66–67. (In Russ.)
  2. Brus TV, Vasil’ev AG, Pyurveev SS, et al. Biomodelirovanie zhirovoi distrofii pecheni razlichnogo geneza. OpenBio: Proceeding of the VIII international scientific and practical conference of young scientists of biophysics, biotechnologists, molecular biologists and virologists. Naukograd Kol’tsovo, 2021. P. 170–171. (In Russ.)
  3. Brus TV, Pyurveev SS, Zabezhinskii MM, Vasil’eva AV. Osobennosti modelirovaniya zabolevanii pecheni razlichnoi ehtiologii. Forcipe. 2021;4(3):162–163. (In Russ.)
  4. Brus TV, Pyurveev SS, Vasilieva AV, et al. Morphological liver changes in case of various ethiology fatty distrophy. Russian Biomedical Research. 2021;6(3):21–26. (In Russ.)
  5. Brus TV, Khaytsev NV, Kravtsova AA. Liver dysfunction in pathogenesis of burn disease and its correction with succinate-containing drugs. Pediatrician (St. Petersburg). 2016;7(4):132–141. (In Russ.) doi: 10.17816/PED74132-141
  6. Vasil’ev AG, Khaitsev NV, Trashkov AP. Praktikum po patofiziologii. Uchebnoe posobie dlya studentov meditsinskikh vuzov. Saint Petersburg: Foliant, 2014. 344 p. (In Russ.)
  7. Vasil’ev AG, Khaitsev NV, Babichev AV, et al. Narusheniya mikrotsirkulyatsii, tromboz, vospalenie. Saint Petersburg: St. Petersburg State Pediatric Medical University Publ., 2019. 28 p. (In Russ.)
  8. Savchenko YuV, Sergievskaya ZA, Lopatieva SO. Non-alcoholic fatty liver degeneration in people of different age groups: a modern view of the problem. University therapeutic journal. 2022;4(1):11–21. (In Russ.)
  9. Stroev YuI, Churilov LP, Bel’gov AYu, Chernova LA. Ozhirenie u podrostkov. Saint Petersburg: Medkniga “EHLBI”, 2003. 216 p. (In Russ.)
  10. Kharrison TR. Vnutrennie bolezni v 10 tomakh. Braunval’d E, Issel’bakher KDzh, Petersdorf RG, et al editors. T. 7: Bolezni organov pishchevareniya. Moscow: Meditsina, 1996. 720 p. (In Russ.)
  11. Khenderson DM. Patofiziologiya organov pishchevareniya. Saint Petersburg: Nevskii dialekt, 1997. 224 p. (In Russ.)
  12. Åberg F, Puukka P, Salomaa V, et al. Risks of light and moderate alcohol use in fatty liver disease: follow-up of population cohorts. Hepatology. 2020;71(3): 835–848. doi: 10.1002/hep.30864
  13. Chang Y, Cho YK, Kim Y, et al. Nonheavy drinking and worsening of noninvasive fibrosis markers in nonalcoholic fatty liver disease: a cohort study. Hepatology. 2019;69(1):64–75. doi: 10.1002/hep.30170
  14. Mitra S, De A, Chowdhury A. Epidemiology of non-alcoholic fatty liver diseases. Transl Gastroenterol Hepatol. 2020;5:161–166. doi: 10.21037/tgh.2019.09.08

Supplementary files

Supplementary Files
1. Fig. 1. Ethanol metabolism in the liver. 1 — endogenous cholesterol synthesis; 2 — NADH reduction. MEOS — microsomal ethanol-oxidizing system; CoA — coenzyme A; HMG-CoA — 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase; AMP + 2Р — adenosine monophosphate + 2 phosphate; ATP — adenosine triphosphate

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2. Fig. 2. General pathogenesis of liver failure

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3. Fig. 3. Metabolism of bilirubin

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Copyright (c) 2022 Brus T.V., Evgrafov V.A.

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