Baveno VII – Renewing consensus in portal hypertension

Franchis, Roberto de; Bosch, Jaime; García–Tsao, Guadalupe; Reiberger, Thomas; Ripoll, Cristina; Abraldes, Juan G.; Albillos, Agustı́n; Baiges, Anna; Bajaj, Jasmohan S.; Bañares, Rafael; Barrufet, Marta; Benajiba, Lina; Berzigotti, Annalisa; Bureau, Christophe; Calvaruso, V.; Cárdenas, Andrés; D’Amico, Gennaro; Gottardi, Andrea De; Dell’Era, Alessandra; Escorsell, Àngels; Fallowfield, Jonathan; Ferral, Héctor; Francque, Sven; Gaba, Ron C.; García‐Pagán, Juan Carlos; Genescà, Joan; Rodrigues, Susana; Gracia-Sanscho, Jordi; Han, G.; Hernández‐Gea, Virginia; Jia, Jidong; Kiladjian, Jean Jacques; Krag, Aleksander; Laleman, Wim; Mura, Vincenzo La; Lens, Sabela; Luo, Xuefeng; Mandorfer, Mattias; Murad, Sarwa Darwish; Paradis, Valérie; Patch, David; Piano, Salvatore; Pinzani, Massimo; Plessier, Aurélie; Primignani, Massimo; Procopeţ, Bogdan; Rautou, P.-E.; Rudler, Marika; Sarin, Shiv Kumar; Schepis, Filippo; Senzolo, Marco; Shah, Vijay H.; Shukla, Akash; Tandon, Puneeta; Téllez, Luís; Thabut, Dominique; Thiele, Maja; Trebicka, Jonel; Tripathi, Dhiraj; Tsochatzis, E.; Turco, Laura; Turón, Fanny; Valla, Dominique; Villanueva, Càndid; Wanless, Ian R.; Yoshiji, Hitoshi

doi:10.1016/j.jhep.2021.12.022

Cited by 1,280 publications

(1,156 citation statements)

References 14 publications

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“…Whether the results obtained in this study can be extrapolated to hepatitis C virus, alcohol or non-alcoholic steatohepatitis-related cirrhosis is not certain. Lastly, recent Baveno VII consensus recommended that six-week mortality should be the primary endpoint for studies on the treatment of acute EVB ( 31 ). However, given the design of the study, we could only define the incidence of rebleeding within 5 days, in-hospital mortality, need for ICU and the length of hospital stay as outcomes.…”

Section: Discussionmentioning

confidence: 99%

Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

et al. 2022

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Background and AimsEmergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in cirrhotic patients with acute EVB.MethodsCirrhotic patients with acute EVB who underwent emergency endoscopy were retrospectively enrolled from 2013 to 2020 across 34 university hospitals from 30 cities. The primary outcome was the incidence of 5-day rebleeding after emergency endoscopy. Subgroup analysis was stratified by Child-Pugh class and bleeding history. A 1:1 propensity score matching (PSM) analysis was performed.ResultsA total of 1,017 and 382 patients were included in EIS group and EVL group, respectively. The 5-day rebleeding incidence was similar between EIS group and EVL group (4% vs. 5%, P = 0.45). The result remained the same after PSM (P = 1.00). Among Child-Pugh class A, B and C patients, there were no differences in the 5-day rebleeding incidence between the two groups after PSM (P = 0.25, 0.82, and 0.21, respectively). As for the patients with or without bleeding history, the differences between EIS group and EVL group were not significant after PSM (P = 1.00 and 0.26, respectively).ConclusionThe nationwide cohort study indicates that EIS and EVL are both efficient emergency endoscopic treatment strategies for acute EVB. EIS should not be dismissed as an economical and effective emergency endoscopic treatment strategy of acute EVB. ClincialTrials.gov number NCT04307264.

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Section: Discussionmentioning

confidence: 99%

Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

et al. 2022

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“…We also generated models stratified by presence of clinically significant portal hypertension (CSPH), defined by either liver stiffness measurement ≥25 kPa on VCTE or presence of varices or collaterals on endoscopy or imaging. 17 Pre-specified subgroup analyses were: sex (female vs. male), etiology (NAFLD/cryptogenic vs. other), age (≥ or <60 years), presence of diabetes, and presence of severe obesity (class 2-3) vs. not. Heterogeneity between the subgroups was computed based on the Cochran Q statistic.…”

Section: Methodsmentioning

confidence: 99%

Hepatic decompensation is accelerated in patients with cirrhosis and alpha-1 antitrypsin Pi∗MZ genotype

et al. 2022

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“…Interventional methods are considered when systemic anticoagulation has not been effective or therapeutic systemic anticoagulation is not possible. The renewed Baveno VII Consensus [17] for Personalized Care of Patients with Portal Hypertension provides guidance for this interdisciplinary evaluation based on clinical parameters and early imaging. Here, it is recommended to make the decision dependent on (I) persistent severe abdominal pain despite anticoagulation therapy, (II) bloody diarrhea, (III) lactic acidosis, (IV) bowel loop distention, or (V) occlusion of second-order radicles of the superior mesenteric vein.…”

Section: Step 3: Interventional Therapy Of Vitt-associated Acute Port...mentioning

confidence: 99%

Covid19 vaccination-associated portal vein thrombosis—An interdisciplinary clinical challenge

Bogovic

Doenecke

Hart

et al. 2022

Clinics and Research in Hepatology and Gastroenterology

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Baveno VII – Renewing consensus in portal hypertension

Cited by 1,280 publications

References 14 publications

Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

Hepatic decompensation is accelerated in patients with cirrhosis and alpha-1 antitrypsin Pi∗MZ genotype

Covid19 vaccination-associated portal vein thrombosis—An interdisciplinary clinical challenge

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