Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Provincia de Buenos Aires, Argentina.
Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Brazil.
Ann Hepatol. 2024 Jan-Feb;29(1):101180. doi: 10.1016/j.aohep.2023.101180. Epub 2023 Nov 19.
The Baveno VII consensus workshop has provided several novel recommendations regarding the management of patients with clinically significant portal hypertension (CSPH). The expert panel summarized the existing data into simple clinical rules to aid clinicians in their clinical practice. The use of non-invasive tests (NITs), especially liver stiffness measurement (LSM), have gain an important role in daily practice. The use of LSM alone or in combination with platelet count can be used to rule-in and rule-out compensated advanced chronic liver disease (cACLD) and CSPH. Further decompensation events were defined as a prognostic stage associated with an even higher mortality than that associated with first decompensation. Moreover, the term hepatic recompensation was introduced in Baveno VII consensus implying a partial or complete regression of the functional and structural changes of cirrhosis after the removal of the underlying etiology. This review will summarize the reader main aspects of Baveno VII consensus regarding the use of NITs in cACLD, analyze further decompensation events, and evaluate recent recommendations for prophylaxis and management of liver decompensation events.
贝伐诺 VII 共识研讨会就伴有临床显著门静脉高压症(CSPH)患者的管理提供了一些新的建议。专家组将现有数据总结为简单的临床规则,以帮助临床医生进行临床实践。非侵入性检查(NITs)的使用,特别是肝脏硬度测量(LSM),在日常实践中发挥了重要作用。LSM 的单独使用或与血小板计数相结合可用于确定代偿性慢性肝病(cACLD)和 CSPH。进一步的失代偿事件被定义为与首次失代偿相关的死亡率更高的预后阶段。此外,Baveno VII 共识引入了肝代偿的概念,这意味着在去除潜在病因后,肝硬化的功能和结构变化部分或完全消退。这篇综述将总结读者对 Baveno VII 共识中 NITs 在 cACLD 中的应用的主要方面,分析进一步的失代偿事件,并评估最近关于预防和管理肝失代偿事件的建议。