Evolving portal hypertension through Baveno VII recommendations

Area of Science:

• Hepatology
• Gastroenterology
• Internal Medicine

Background:

• The Baveno VII consensus workshop established new recommendations for managing patients with clinically significant portal hypertension (CSPH).
• Existing data were synthesized into practical clinical rules for healthcare providers.
• Non-invasive tests (NITs), particularly liver stiffness measurement (LSM), are increasingly vital in clinical practice.

Approach:

• This review summarizes key aspects of the Baveno VII consensus concerning NITs in compensated advanced chronic liver disease (cACLD).
• It analyzes prognostic staging related to further decompensation events and their associated mortality.
• Recent recommendations for preventing and managing liver decompensation are evaluated.

Key Points:

• LSM, alone or with platelet count, can effectively rule in/out compensated advanced chronic liver disease (cACLD) and CSPH.
• Further decompensation events represent a prognostic stage with significantly higher mortality than initial decompensation.
• Hepatic recompensation, the regression of cirrhosis changes after etiological factor removal, was introduced.

Conclusions:

• The Baveno VII consensus provides updated strategies for utilizing NITs in cACLD management.
• Understanding further decompensation events and hepatic recompensation is crucial for patient prognosis.
• The review highlights current prophylaxis and management guidelines for liver decompensation events.