BookRoberto de Franchis, editor.
Summary: This book, the seventh in a series of proceedings volumes that began in 1995, reviews the latest developments in the diagnosis and management of cirrhosis and portal hypertension. It addresses a broad range of topics, including: risk stratification, HVPG, non-invasive surrogates for cACLD, CSPH, varices, progression and regression of cirrhosis, impact of etiological therapy on cirrhosis, impact of non-etiological novel therapies on cirrhosis, prevention of first/further decompensation, acute variceal hemorrhage, and Vascular Liver Disorders in Cirrhosis (VALDIG). The book is a compilation of lectures and important consensus statements from the Seventh Baveno International Consensus Workshop on Portal Hypertension, the latest in a series of workshops held every five years for hepatologists with an interest in the field. Portal Hypertension VII offers a valuable reference guide for clinical and research fellows in Gastroenterology and Hepatology and will inspire new research projects in the promising areas identified by the experts of the Baveno VII Faculty.
Contents:
Intro
Preface
Thomas D. Boyer, MD (1943-2018)-A Tribute
Memories of Prof Andrew K. Burroughs, MD (1953-2014)
Tribute to Roberto J. Groszmann
Tribute to Prof Luigi Pagliaro (1931-2020)
Contents
Contributors
Part I: Introductory Lectures
1: Introduction: Baveno I to Baveno VII ... and Beyond
Baveno I to VI
Attendance at the Baveno Workshops
Publications Derived from the Baveno Workshops
Impact of the Baveno Consensus on the Medical Literature
Validation of the Baveno Definitions and Recommendations
Beyond Baveno VII, the Baveno Cooperation The Baveno I-VII Workshops Were a Concerted Effort of the Following
Speakers and Chairpersons
References
2: New Concepts in Risk Stratification
Introduction
Risk Prediction and Probabilistic Thinking
Diagnosis as a Risk Prediction Problem
Decision Thresholds and Risk Stratification
Risk Prediction and the Interpretation of Treatment Effects in Randomized Controlled Trials
Conclusion
References
3: Clinical Stages and Ordinal Outcomes in Portal Hypertension
Background
Definition and Incidence of Decompensation
Clinical Stages of Cirrhosis Ordinal Outcomes
Examples of Application of an Ordinal Outcome in Compensated Cirrhosis
Ordinal Outcomes for Randomized Clinical Trials in Cirrhosis
Sample Size Estimation with Ordinal Compared to Binary Outcomes
Using Ordinal Outcomes in Portal Hypertension
Conclusions
References
4: Lifestyle and Genetic Modifiers of Liver Disease Progression
Lifestyle Modifiers of Liver Disease Progression
Unhealthy Lifestyle
Alcohol
Obesity
Malnutrition, Sarcopenia, and Frailty
Cigarette Smoke
Healthy Lifestyle-Protective Factors
Physical Activity and Exercise Coffee Consumption and Mediterranean Diet
Genetic Modifiers of Progression of cACLD
Individual Genetic Variants
PNPA3 and HSD17B13
SERPINA1/Alpha-1 Antitrypsin Deficiency
NOD2
NR1H4/FXR
Conclusions and Outlook
References
Part II: HVPG as a Gold Standard
5: HVPG as a Gold Standard: Accuracy Is Essential
Procedure Technique
Pressure Measurements and Data Recording
Technical Aspects
Diagnosis of Clinically Significant Portal Hypertension (CSPH) and Prediction of Main Outcomes in Patients with Different Etiologies of Cirrhosis
Variceal Hemorrhage Hepatocellular Carcinoma (HCC)
Survival
Assessment of HVPG in Patients Receiving NSBBs for Prevention of Variceal Hemorrhage and Decompensation
HVPG Predicts Risk of Decompensation and Mortality after Hepatic and Non-hepatic Surgery
Patients with Cirrhosis and HCC: Candidates for Hepatic Resection
Patients with Cirrhosis Who Undergo Extrahepatic Surgery
PPG in the Setting of Tips
PPG Measurement
Anatomic Location for PPG Measurement
Optimal PPG Threshold for Portal Hypertensive Bleeding/Ascites
PPG Thresholds in Overshunting Adverse Events
References