Management of Portal Hypertension in Patients with Acute-on-Chronic Liver Disease
Copyright © 2023 Elsevier Inc. All rights reserved..
Portal hypertension is central to the pathogenesis of complications of cirrhosis, including acute-on-chronic liver failure (ACLF). Both nonselective beta-blockers and preemptive transjugular portal-systemic stent shunt can lower portal pressure, reducing the risk of variceal bleeding, a known trigger for ACLF. However, in patients with advanced cirrhosis, both could potentially induce ACLF by causing hemodynamic instability and hepatic ischemia, respectively, and therefore must be used with caution. Lowering portal pressure with vasoconstrictor such as terlipressin can reverse the kidney failure but careful patient selection is key for success, with careful monitoring for complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Clinics in liver disease - 27(2023), 3 vom: 15. Aug., Seite 717-733 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wong, Florence [VerfasserIn] |
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| Links: |
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| Themen: |
Acute-on-chronic liver failure |
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| Anmerkungen: |
Date Completed 30.06.2023 Date Revised 02.07.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.cld.2023.03.014 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM358815851 |
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| 520 | |a Portal hypertension is central to the pathogenesis of complications of cirrhosis, including acute-on-chronic liver failure (ACLF). Both nonselective beta-blockers and preemptive transjugular portal-systemic stent shunt can lower portal pressure, reducing the risk of variceal bleeding, a known trigger for ACLF. However, in patients with advanced cirrhosis, both could potentially induce ACLF by causing hemodynamic instability and hepatic ischemia, respectively, and therefore must be used with caution. Lowering portal pressure with vasoconstrictor such as terlipressin can reverse the kidney failure but careful patient selection is key for success, with careful monitoring for complications | ||
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