Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases.

doi:10.1002/HEP.28906

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Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases.

Journal Article•DOI•

Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases.

Guadalupe Garcia-Tsao¹, Juan G. Abraldes², Annalisa Berzigotti³, Jaime Bosch⁴, Jaime Bosch³ - Show less +1 more•Institutions (4)

Yale University¹, University of Alberta², University of Bern³, University of Barcelona⁴

01 Jan 2017-Hepatology (Hepatology)-Vol. 65, Iss: 1, pp 310-335

TL;DR: This guidance provides a data-supported approach to risk stratification, diagnosis, and management of patients with cirrhosis and portal hypertension (PH), varices, and variceal hemorrhage (VH), and statements are based on the following.

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About: This article is published in Hepatology.The article was published on 2017-01-01. It has received 1397 citations till now. The article focuses on the topics: Risk assessment & Portal hypertension.

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The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases.

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Naga Chalasani¹, Zobair M. Younossi², Joel E. Lavine³, Michael Charlton⁴, Kenneth Cusi⁵, Mary E. Rinella⁶, Stephen A. Harrison⁷, Elizabeth M. Brunt⁸, Arun J. Sanyal⁹ - Show less +5 more•Institutions (9)

Indiana University¹, Inova Fairfax Hospital², Columbia University³, University of Chicago⁴, University of Florida⁵, Northwestern University⁶, Pinnacle Financial Partners⁷, Washington University in St. Louis⁸, Virginia Commonwealth University⁹

01 Jan 2018-Hepatology

TL;DR: This guidance provides a data-supported approach to the diagnostic, therapeutic, and preventive aspects of NAFLD care.

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EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis

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Paolo Angeli, Mauro Bernardi, Càndid Villanueva, Claire Francoz, Rajeshwar P. Mookerjee, Jonel Trebicka, Aleksander Krag, Wim Laleman, Pere Ginès - Show less +5 more

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TL;DR: The panel of experts, having emphasised the importance of initiating aetiologic treatment for any degree of hepatic disease at the earliest possible stage, extended its work to all the complications of cirrhosis which had not been covered by the European Association for the Study of the Liver guidelines.

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1,534 citations

Cites background from "Portal hypertensive bleeding in cir..."

...Recommendations regarding management of coagulopathy and thrombocytopenia cannot be made based on currently available data.(168,169,199) As mentioned above vasoactive drug therapy should be initiated as soon as AVH is suspected....
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...024 which is considered the main treatment outcome by consensus.(168,199) Blood volume restitution should be initiated promptly to restore and maintain haemodynamic stability to ensure tissue perfusion and oxygen delivery....
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...024 prophylactic antibiotics, up to 10–15% of patients with AVH have persistent bleeding or early rebleeding.(195,199) In such cases, TIPS should be considered as the rescue therapy of choice....
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...Antibiotic prophylaxis is recommended because it reduces the incidence of infections and improves control of bleeding and survival.(199,208) Ceftriaxone (1 g/24 h) for up to seven days, is the first choice in patients with advanced cirrhosis, in those on quinolone prophylaxis and in hospital settings with high prevalence of quinolone-resistant bacterial infections....
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ACG Clinical Guideline: Alcoholic Liver Disease

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Ashwani K. Singal¹, Ramon Bataller², Joseph Ahn³, Patrick S. Kamath⁴, Vijay H. Shah⁴ - Show less +1 more•Institutions (4)

University of Alabama at Birmingham¹, University of Pittsburgh², Oregon Health & Science University³, Mayo Clinic⁴

16 Jan 2018-The American Journal of Gastroenterology

TL;DR: General measures in patients hospitalized with ALD include inpatient management of liver disease complications, management of alcohol withdrawal syndrome, surveillance for infections and early effective antibiotic therapy, nutritional supplementation, and treatment of the underlying alcohol-use disorder.

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Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection

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Marc G. Ghany¹, Timothy R. Morgan²•Institutions (2)

National Institutes of Health¹, Veterans Health Administration²

01 Feb 2020-Hepatology

TL;DR: The American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA) initiated the hepatitis C virus guidance project (hereafter HCV guidance) in 2013 and disseminates up-to-date, peer-reviewed, unbiased, evidence-based recommendations to aid clinicians making decisions regarding the testing, management, and treatment of HCV infection.

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Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases.

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Arizona State University¹, University of California, Davis², Yale University³, University of Miami⁴, University of Texas Southwestern Medical Center⁵

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TL;DR: This American Association for the Study of Liver Diseases (AASLD) 2018 Practice Guidance on Primary Biliary Cholangitis is an update of the PBC guidelines published in 2009, and provides a data-supported approach to screening, diagnosis, and clinical management of patients with PBC.

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402 citations

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References

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Journal Article•DOI•

Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies.

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Gennaro D'Amico¹, Guadalupe Garcia-Tsao², Luigi Pagliaro¹•Institutions (2)

University of Palermo¹, Yale University²

01 Jan 2006-Journal of Hepatology

TL;DR: The natural history of cirrhosis is outlined, the model for end stage liver disease (MELD) has replaced the Child–Pugh score in the United States for prioritizing liver donor allocation and a systematic review of the literature regarding predictors of mortality in cirrhotic patients is reported on.

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2,427 citations

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Expanding consensus in portal hypertension Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension

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Roberto de Franchis¹•Institutions (1)

University of Milan¹

01 Sep 2015-Journal of Hepatology

TL;DR: The aims of these meetings were to develop definitions of key events in portal hypertension and variceal bleeding, to review the existing evidence on the natural history, the diagnosis and the therapeutic modalities of portal hypertension, and to issue evidence-based recommendations for the conduct of clinical trials and the management of patients.

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2,317 citations

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Revising consensus in portal hypertension: Report of the Baveno V Consensus Workshop on methodology of diagnosis and therapy in Portal Hypertension

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Roberto de Franchis¹•Institutions (1)

University of Milan¹

01 Jul 2005-Journal of Hepatology

TL;DR: A Baveno V workshop was held on May 21–22, 2010, attended by many of the experts responsible for most of the major achievements of the last years in this field, and produced consensus statements on some important points, although some issues remained unsettled.

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2,074 citations

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Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis

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Guadalupe Garcia-Tsao¹, Arun J. Sanyal², Norman D. Grace³, William D. Carey⁴, Margaret C. Shuhart, Gary L. Davis, Kiran Bambha, Andrés Cárdenas, Stanley Martin Cohen, Timothy J. Davern, Steven L. Flamm, Steven B. Han, Charles D. Howell, David R. Nelson, K. Rajender Reddy, Bruce A. Runyon, John B. Wong, Colina Yim, Nizar N. Zein, John M. Inadomi, Darren Baroni, David I. Bernstein, William R. Brugge, Lin Chang, William D. Chey, John T. Cunningham, Kenneth R. DeVault, Steven A. Edmundowicz, Ronnie Fass, Kelvin Hornbuckle, Costas Kefalas, Timothy R. Koch, Jenifer K. Lehrer, Anthony Lembo, John O'Brien, John Papp, Henry P. Parkman, Albert Roach, Richard E. Sampliner, Amnon Sonnenberg, Subbaramiah Sridhar, Miguel A. Valdovinos, John J. Vargo, Marcelo F. Vela, Nizar N. Zein - Show less +41 more•Institutions (4)

Yale University¹, Virginia Commonwealth University², Harvard University³, Cleveland Clinic⁴

01 Sep 2007-Hepatology

TL;DR: Prevention and Management of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis Guadalupe Garcia-Tsao, M.D., co-authors.

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1,467 citations

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Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study

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Patrick Marcellin¹, Edward Gane², Maria Buti, Nezam H. Afdhal³, William Sievert⁴, Ira M. Jacobson⁵, Mary Kay Washington⁶, George Germanidis⁷, John F. Flaherty, Raul Aguilar Schall, Jeffrey D. Bornstein, Kathryn M. Kitrinos, G. Mani Subramanian, John G. McHutchison, E. Jenny Heathcote⁸ - Show less +11 more•Institutions (8)

French Institute of Health and Medical Research¹, Auckland City Hospital², Beth Israel Deaconess Medical Center³, Monash Medical Centre⁴, Cornell University⁵, Vanderbilt University⁶, AHEPA University Hospital⁷, University of Toronto⁸

09 Feb 2013-The Lancet

TL;DR: In patients with chronic HBV infection, up to 5 years of treatment with tenofovir DF was safe and effective, and long-term suppression of HBV can lead to regression of fibrosis and cirrhosis.

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1,431 citations

"Portal hypertensive bleeding in cir..." refers background in this paper

...worsening of liver fibrosis, cirrhosis decompensation, and lack of regression of cirrhosis in patients with viral cirrhosis,((29-31)) whereas even moderate alcohol intake can lead to worsening PP and has been shown to worsen prognosis of hepatitis C virus (HCV)- and nonalcoholic steatohepatitis (NASH)-related cirrhosis....
[...]
...Because thin septa are considered more susceptible to resorption/degradation, patients in this stage are the most likely to show regression to a noncirrhotic stage with treatment of etiology,((74)) as has been demonstrated in patients with HBV (hepatitis B virus) cirrhosis.((31)) In addition to eliminating or suppressing the etiologic agent (e....
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