<s>[INST] Hi I was told my son who has special needs has a very lumpy liver and that he has cirrohosis of the liver. Can you tell me what tests are needed to see what stage he is at? I have been given a hospital apt but its not until November 2014 I hope to bring him private, Kind regards Irene [/INST] Welcome at Chat Doctor I have gone through your query and being your doctor I completely understand your health concerns.... There are different grading system to assess the severity of cirrhosis... The most commonly used and widely accepted us CHILD PUGH scoring... It requires serum bilirubin levels, PT INR along with serum albumin levels measurement.it also requires assessment of ascites and encephalopathy.... slightly deranged values counts one for individual parameter and score increases from 2 to 3 as severity and derangement in these parameters progresses.... These are total five parameters and overall child score of less than 4 shows class A cirrhosis and score of 5 to 9 is children B and greater than 10 is children c... Five year survival rate decreases as score increases. It is 70% for child A and 50% for child B.... Consult your hepatologist for proper interpretation and any comorbidity associated with it... Hope your query is adequately answered.  Regards Chat Doctor.  </s>