Signs of Improvement in Liver Cirrhosis: Key Indicators to Monitor

When cirrhosis is accompanied by abnormal liver function, monitoring specific medical markers can help determine if the condition is improving. These indicators provide valuable insight into the liver's recovery process and overall health.

1. Albumin Levels: Albumin is a key protein produced by the liver. A normal albumin level ranges between 40–50 g/L. If levels were previously below 40 g/L—such as 35 g/L or lower—and begin to rise toward the normal range, it indicates improved synthetic function of the liver.

2. Liver Enzymes (ALT and AST): Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are enzymes that increase when liver cells are inflamed or damaged. A decline to normal levels suggests reduced liver inflammation and cellular damage.

3. Coagulation Function: The liver plays a major role in blood clotting. Prothrombin activity and the international normalized ratio (INR) are two key measurements. An improvement in prothrombin activity to above 60%, or ideally over 80%, shows better coagulation ability. Likewise, a drop in INR to below 1.5—or even closer to the ideal range below 1.2—also reflects progress in liver function.

4. Liver Stiffness: Measured through transient elastography, liver stiffness is a direct indicator of fibrosis or cirrhosis. A reduction in the attenuation coefficient suggests a decrease in liver hardness. For example, if liver stiffness was initially above 17 kPa—indicating cirrhosis—and drops below this threshold, it signifies meaningful improvement.

5. Bilirubin and Bile Duct Markers: Decreasing total bilirubin levels, along with reductions in gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP), suggest better bile metabolism and recovery of bile duct function. These changes indicate that the liver is regaining its ability to process and excrete bilirubin effectively.