Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia
GAVE PHG Portal hypertension (PHTN) PHTN is not necessary for the development of GAVE [6, 7] 70 % of patients with PHTN develop PHG [1], degree of PHTN correlates…
Delivering Quality Care to Patients with Cirrhosis: A Practical Guide for Clinicians
Fig. 33.1 Many patients with cirrhosis fail to receive evidence-based treatments [3–6]. HCC hepatocellular carcinoma, SBP spontaneous bacterial peritonitis, Abx antibiotics Measuring Quality Another key feature of the QI definition…
Ascites and Refractory Ascites
Fig. 13.1 The pathophysiology of ascites. RAAS renin–angiotensin–aldosterone system, ADH antidiuretic hormone, NO nitric oxide In an effort to maintain homeostasis, this new altered hemodynamic state and renal response results…
Gastric and Ectopic Varices
Fig. 11.1 Classification of gastric varices. Gastroesophageal varices: lesser curve GOV1 and fundal GOV2. Isolated gastric varices; fundal IGV1 and other IGV2. Reproduced with permission from John Wiley and Sons…
Portal Vein Thrombosis
Grade 1. Cross-sectional obstruction of less than 50 % of the portal vein lumen Minimal or absent extension into the superior mesenteric vein Grade 2. Cross-sectional obstruction of more than…
Ethical Issues in End-Stage Liver Disease: A Framework for Assessment and the Challenges
A. Obtain an advance directive; if not available and the patient is competent, encourage one be executed B. Begin planning ahead for end-of-life issues C. Anticipate and schedule regular reevaluation…
Palliative Care in Cirrhosis
Poor performance status (palliative performance scale and Karnofsky scale) Advanced age Malnutrition Comorbid illness Increasing organ dysfunction Hospitalization for acute decompensation Principles of Palliative Care Palliative care is rooted in…
Noninvasive Markers of Fibrosis in the Assessment of Cirrhosis
Highly sensitive and specific to identify different stages of fibrosis Applicable to the monitoring of disease progression or regression as part of the natural history of liver disease or treatment…
Measurement of Portal Pressure and Transjugular Liver Biopsy
Fig. 7.1 A typical tracing of a hepatic venous pressure gradient (HVPG). Equilibration of WHVP requires over 20 s. The HVPG is calculated as the difference between WHVP and free hepatic…
Promoting a Healthy Lifestyle, Managing Hyperlipidemia, Diabetes Mellitus, Hypertension, and Immunizations in Patients with Cirrhosis
Vaccine Before transplantation After transplantation Influenza Inactivated Live attenuated Recommended (yearly) If inactivated not available (2 weeks before transplantation) Recommended (yearly) Not recommended Hepatitis B Recommended if seronegative (3–4 high-dose…
