Doctors Macarena Simón-Talero and Salvador Augustin, from the http://en.vhir.org/portal1/grup-presentacio.asp?s=recerca&contentid=187009&idrefer=187010 Research Group on Liver diseases of VHIR, led by Dr. Joan Genescà, have published a stud that proves the relation between the appearance of collateral portosystemic shunts and a greater level of complications and mortality rate from cirrhosis.The shunts of the study are a compensation mechanism that the body generates when trying to reduce the portal hypertension and, therefore, avoid the cirrhotic liver's "burden".Published at https://www.gastrojournal.org/article/S0016-5085(18)30069-6/abstract Gastroenterology magazine, the most relevant magazine within the field of hepatology, it gathered the biggest international consortium to date in the study of cirrhosis and the appearance of collateral portosystemic shunts, coordinating 14 international research centers and more than 1700 patients. "The data out of the patients has been collected over 5 years to determine if the presence of collateral portosystemic shunts is linked with the complications that show up along the development of the disease. We have studied the relation due to the lack of knowledge on the real usefulness of the collateral shunts as a compensatory mechanism, or otherwise, its usefulness to predict liver complications and mortality", details Dr. Macarena Simón - Talero.The researchers detected that up to 60% of the patients presented collateral portosystemic shunts. They carried out a follow up to understand the evolution of the disease, and detected that those patients with collateral shunts and good hepatic function -therefore, non-priority for an hepatic transplant- would develop more complications that those patients with a bad hepatic function but without collateral shunts - that were a priority for the transplant-.Cirrhosis complications:The most incident complications of cirrhosis are ascites (liquid presence at the abdominal cavity) and bleeding, leading to mortality due to the liver's total loss of function.On the other hand, it can also lead to the hepatic encephalopathy, also developed in half of the patients with large Spontaneous portosystemic shunts -a 30% more than in patients without shunts- independently of the liver's function. "The shunts increase the encephalopathy frequency when deviating the blood, that instead being filtered through the liver from toxins, goes directly to the general circulation, triggering a neurological toxicity that generates a range of manifestations that go from mild mental disorders to behavior changes, loss of motor skills, drowsiness and coma", details Dr. Macarena Simón-Talero.By this means, the presence of portosystemic shunts means a worst development of cirrhosis and, therefore, a risk marker for its patients. As Dr. Macarena Simón-Talero explains, "we need to take into account the appearance of portosystemic shunts to have more under control those patients when their liver function fails. These patients will suffer more complications and a higher mortality rate, so we need to start a closer follow up that would benefit them with a closer surveillance, in case that more intensive therapy are needed".A present chronic disease:Nowadays, and after a decreasing trend, cirrhosis still affects between 1 and 2% of the Spanish population, especially man from 50 years old on.This chronic disease is triggered in 60% of the cases by the excessive alcohol consumption, although it is also commonly provoked by Hepatitis C virus infection or the over accumulation of fat in the liver due to non-alcoholic causes (non-alcoholic steatohepatitits), affecting the liver and with complications that spread all over the body, reaching lethal consequences.