This refers to severe scarring or fibrosis of the liver which occurs as the end result of ongoing, chronic inflammation of the liver. With prolonged liver inflammation (hepatitis), healthy hepatocytes die and are replaced with fibrous tissue. Once enough liver cells have died, the fibrous tissue connects throughout the liver and forms nodules. Cirrhosis can result from any chronic inflammatory condition of the liver but in the U.S, the most common causes are alcohol, non-alcoholic fatty liver (see below) and chronic hepatitis C infection. It is possible for the liver to still function normally even with cirrhosis present and this is referred to as “compensated” cirrhosis. However, once enough healthy liver cells have died the liver is no longer able to function properly and this is called “decompensated” cirrhosis. Once someone has decompensated cirrhosis they will ultimately need a liver transplant to avoid death.