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The transition from compensated cirrhosis to decompensated cirrhosis (DC) heralds a watershed in the nature and prognosis of the disease. DC is a systemic disease, characterised by multiorgan\/system dysfunction, including haemodynamic and immune dysfunction. In this second part of our three-part series on the outpatient management of cirrhosis, we address outpatient management of DC, including management of varices, ascites, HE, nutrition, liver transplantation and palliative care. We also introduce an outpatient DC care bundle. For recommendations on screening for osteoporosis, hepatocellular carcinoma surveillance and vaccination see part one of the guidance. Part 3 of the guidance focusses on special circumstances encountered in patients with cirrhosis, including surgery, pregnancy, travel, management of bleeding risk for invasive procedures and portal vein thrombosis.<\/jats:p>","DOI":"10.1136\/flgastro-2023-102431","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T13:20:43Z","timestamp":1690550443000},"page":"462-473","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis \u2013 part 2: decompensated cirrhosis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8367-4232","authenticated-orcid":false,"given":"Dina","family":"Mansour","sequence":"first","affiliation":[{"name":"Gateshead Health NHS Foundation Trust, Gateshead, UK"},{"name":"Newcastle University, Newcastle upon Tyne, 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