Cirrhosis of the Liver Community
Stages of cirrhosis
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Cirrhosis is the end result of chronic liver damage caused by chronic liver diseases. The purpose of the community is to share support and information with Cirrhosis of the Liver patients and their loved ones. Topics in the community include: causes, clinical trials, complications, family issues, living with Cirrhosis of the Liver, prognosis, research, surgery, treatments

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Stages of cirrhosis

A friend was recently diagnosed with cirrhosis ( hep c)
stage 6/6. I thought there were only 4 stages of liver disease, not 6. Anyone know what the pathology report cirrhosis stage 6/6 might mean? Thank you.
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stage 6?
Ishak stage 6 = Metavir stage 4
"Cirrhosis, probable or definite."

Grading and Staging

There are a couple of ways to read a liver biopsy. The most common scoring methods are known as the Metavir and the Ishak (modified Knodell score).


The Metavir scoring system was set up just for patients with hepatitis C. The scoring uses both a grade and a stage system. The
grade tells you about the activity or amount of swelling and irritation (inflammation). The stage tells you the amount of fibrosis
or scarring.
The grade is given a number based on the amount of inflammation. This is usually scored from “0-4.” A “0” is no activity, a “2” is moderate activity, and
“3” or “4” are severe activity. The amount of inflammation is important because it may lead to eventual scarring or damage.

The fibrosis score is also assigned a number from 0-4:
 0 = no scarring
 1 = minimal scarring
 2 = scarring has occurred and is inside the areas of
the liver including blood vessels
 3 = bridging fibrosis (the fibrosis is spreading and
connecting to other areas that contain fibrosis)
 4 = cirrhosis or advanced scarring of the liver

Ishak Modified HAI (1995).

The fibrosis scores are defined as follows:

0, no fibrosis
1, fibrous expansion of some portal areas, with or without short fibrous septa
2, fibrous expansion of most portal areas, with or without short fibrous septa
3, fibrous expansion of most portal areas with occasional portal to portal bridging
4, fibrous expansion of most portal areas with marked bridging (portal to portal as well as portal to central)
5, marked bridging with occasional nodules (incomplete cirrhosis);
6, cirrhosis, probable or definite.

Hector thank you again. A friend asked me to talk to a friend of his about his Hep C and cirrhosis. I was confused when he told me  his numbers of his biospy. "Pathology report says stage 6/6, also mildly active chronic hepititas". Trying to guide him to a possible tranx hosiptal ( Mayo is close). I have never heard of this grading 6/6. . I thought a possible meld score or a fibrosis number.
Anyhow thanks again!!!!!!
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