Portal Hypertension and Ascites: Patient-and Population-centered Clinical Practice Guidelines by the Italian Association for the Study of the Liver (AISF). Issue 9 (September 2021)

• Record Type: Journal Article
• Authors: Bruno, Raffaele; Cammà, Calogero; Caraceni, Paolo; D'Amico, Gennaro; Grattagliano, Ignazio; La Mura, Vincenzo; Riggio, Oliviero; Schepis, Filippo; Senzolo, Marco; Angeli, Paolo; de Franchis, Roberto
• Is Part Of: Digestive and liver disease. Volume 53:Issue 9(2021)
• Page Start: 1089
• Page End: 1104
• Publication Date: 2021-09
• Subjects: Portal hypertension -- Esophageal varices -- Variceal bleeding -- Ascites -- Acute kidney injury -- Hepatorenal syndrome; ACLF Acute-on-chronic liver failure -- AKD Acute kidney disease -- AKI Acute kidney Injury -- ALD Alcohol-related liver disease -- AVB Acute esophageal variceal bleeding -- BT Bacterial translocation -- CACLD Compensated advanced chronic liver disease -- CKD Chronic kidney disease -- CPGs High-quality clinical practice guidelines -- CSPH Clinically significant PH -- CTP Child-Turcotte-Pugh -- DAAs Direct antiviral agents -- GOV Gastro-oesophageal varices -- HVPG Hepatic venous pressure gradient -- ICA International Club of Ascites -- IGV Isolated gastric varices -- LSM Liver stiffness measurement -- LT Liver transplantation -- MELD Model for End-Stage Liver Disease -- NSBBs Non-selective beta-blockers -- PH Portal hypertension -- PLT Platelet count -- PVT Portal vein thrombosis -- RRT Renal replacement therapy -- SBP Spontaneous bacterial peritonitis -- sCr Serum creatinine -- SLK Simultaneous liver kidney transplantation -- SVR Sustained virologic response -- TE Transient elastography -- VH Variceal hemorrhage -- VNT Varices needing prophylactic treatment -- VKA Vitamin K antagonist; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.06.021
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Portal hypertension and ascites are two crucial events in the natural history of liver cirrhosis, whose appearance marks a downward shift in the prognosis of the disease. Over the years, several international and national societies have issued clinical practice guidelines for the diagnosis and management of portal hypertension and ascites. The present document addresses the needs of an updated guidance on the clinical management of these conditions. Accordingly, the AISF Governing Board appointed a multi-disciplinary committee of experts for drafting an update of the most recent EASL Clinical Practice Guidelines. The aim of this work was to adapt the EASL recommendations to national regulations and resources, local circumstances and settings, infrastructure, and cost/benefit strategies to avoid duplication of efforts and optimize resource utilization. The committee defined the objectives, the key issues and retrieved the relevant evidence by performing a systematic review of the literature. Finally, the committee members (chosen on the basis of their specific expertise) identified the guidelines' key questions and developed them following the PICO format (Population, Intervention, Comparison, Outcomes). For each of the PICO questions, the systematic review of the literature was made on the most important scientific databases (Pubmed, Scopus, Embase)