Can the liver not recover from cirrhosis caused by alcohol related damage?

Question

The liver can regenerate itself if part of it is damaged or cut away in surgery (Michalopoulos, 2007).

I have been looking at liver damage caused by excess alcohol consumption and according to the NHS,

There's no cure for cirrhosis at the moment.

and

If your liver is severely damaged, a liver transplant may be the only treatment option.

Can you not cut away the damaged area and allow the liver to regenerate or is this kind of damage extensive to the point that the whole liver is damaged?

If the damage is extensive, could you not cut a portion away for regeneration and after regeneration is complete, revisit for another portion to be cut away for regeneration?

References

Michalopoulos, G. K. (2007). Liver regeneration. Journal of cellular physiology, 213(2), 286-300. https://doi.org/10.1002/jcp.21172

Answer 1

At present time, hepatic cirrhosis is still an irreversible end stage chronic disease (Johnson and Sherding, 2006). In a nutshell its featured by successive cycles of injury/repair and inflammation that result in excessive deposition of collagen on the hepatocytes (Zhou, 2014).

Can you not cut away the damaged area and allow the liver to regenerate or is this kind of damage extensive to the point that the whole liver is damaged?

Yes, it's a lesion that affects the entire liver

when the entire liver becomes scarred, it shrinks and hardens, which is called cirrhosis

If the damage is extensive, could you not cut a portion away for regeneration and after regeneration is complete, revisit for another portion to be cut away for regeneration? In cirrhosis the whole liver is damaged and thus the ability to regeneration is compromised

The liver is indeed a highly regenerative organ, but only if it's still healthy enough to do so and doesn't have extensive scar tissue. Once cirrhosis is present, your liver's regeneration becomes very limited. That's why in most cases, cirrhosis can't be reversed.

Although some steps are being made when regarding hepatic fibrosis, the most reliable strategy for reversal of cirrhosis is the treatment of the underlying aetiology (Sohrabpour, Mohamadnejad and Malekzadeh, 2012)