ArticleJHEP reports : innovation in hepatology2024
Persistent varices in cured patients: Understanding the role of hepatic venous pressure gradient.
Article in JHEP reports : innovation in hepatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF.Hepatology (Baltimore, Md.) · 2026Article
- A multisociety consensus statement on a new common definition and diagnostic criteria for PSVD or NCPF.Hepatology international · 2026Article
- Cirrhotic portal hypertension treated with a 5-hydroxytryptamine receptor 1A antagonist.Journal of translational internal medicine · 2026Article
- Assessment of Liver Fibrosis Stage and Cirrhosis Regression After Long-Term Follow-Up Following Sustained Virological Response.Diagnostics (Basel, Switzerland) · 2026Article
- Baveno Criteria Spare Endoscopies Among Patients With Compensated Cirrhosis Within a Large US Healthcare System.Gastro hep advances · 2026Article
- Predicting decompensation risk in compensated HBV cirrhosis: Eternal sunshine for a spotless mind?: Editorial on "Baveno VI-SSM stratifies the risk of portal hypertension-related events in patients with HBV-related cirrhosis".Clinical and molecular hepatology · 2026Article
- Recompensation of Liver Cirrhosis: Definition, Mechanism, Etiological Differences, Prognosis, and Challenges.Canadian journal of gastroenterology & hepatology · 2026Review
- MELD 3.0 score in prediction of varices and comparison with its previous versions in patients undergoing esophago-gastro-duodenoscopy for variceal screening or band ligation.Pakistan journal of medical sciences · 2025Article
- Future research direction of portal hypertension based on Baveno VII.Chinese medical journal · 2025Review
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background & Aims: Etiologic factor removal (ER) drives recompensation and improves portal hypertension in cirrhosis. Esophageal varices (EV) and portosystemic shunts (PSS) have been found in patients despite hepatic venous pressure gradient (HVPG) dropping below 10 mmHg after ER, questioning HVPG accuracy in reflecting true portal pressure in the setting of ER. We aim to evaluate the correlation of HVPG with direct portal pressure (DPP) in patients with persistence of EV after ER despite HVPG <10 mmHg. Methods: This is a bicentric 'proof of concept' study evaluating HVPG and ultrasound-guided percutaneous DPP in patients with HCV or alcohol-related cirrhosis with persistent varices and HVPG <10 mmHg after at least 5 years of ER. Results: Seven patients with HCV and three with alcohol-related cirrhosis with persistent varices and HVPG <10 mmHg after at least 5 years of ER were included. At evaluation, all patients had a patent portal vein and were compensated. The median platelet count was 129.5 (IQR 95-145) × 10 Conclusions: HVPG accurately reflects PPG in the context of HCV and alcohol-related cirrhosis regression. After ER, EV may persist despite HVPG <10 mmHg. The benefit of prophylaxis in patients with EV and HVPG <10 mmHg is unknown. Future studies with clinical endpoints are needed to validate our findings. Impact and implications: Despite a favorable evolution after the removal of the etiologic factor, varices persist in some patients, and there is a lack of concise guidelines for the evaluation and management of portal hypertension in this population. Our research underscores the persistence of varices in the absence of clinically significant portal hypertension and significantly demonstrates the accuracy of hepatic venous pressure gradient (HVPG) in reflecting portal vein pressure in this specific patient group. These findings emphasize the crucial role of HVPG in the assessment of portal hypertension after etiologic factor removal and lay the groundwork for further investigation into clinical outcomes and the necessity of non-selective beta-blockers in individuals with persistent varices after the removal of etiologic factor.
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