Cirrhosis represents a considerable clinical challenge and ranks as the 14th most common cause of mortality globally resulting in 1 million deaths annually, 1 200 000 of which are in the USA and Europe. 2,3 Different pathways all ultimately lead to necroinflammation and fibrogenesis, which increase vascular resistance and reduces liver function. 4 The change in liver histology produces the well-known clinical picture of portal hypertension with its complications of bleeding from oesophageal varices, ascites, encephalopathy and circulatory disturbances. 5 Liver failure leads to abnormal hepatic clearance and biliary