Hepatic Venous Pressure Gradient Measurements in Children

Ebel, Noelle H.; Carlin, Kristen; Shaffer, Michele L.; Shivaram, Giridhar M.; Hawkins, C. Matthew; Lane, Erin R.; Cooper, Kara; Lindquester, Will S.; Gadodia, Gaurav; Murray, Karen F.

doi:10.1097/mpg.0000000000002327

Cited by 14 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 37 However, in contradiction to this, a retrospective study in 41 children demonstrated no correlation between HVPG and degree of hepatic fibrosis or the presence of varices or variceal bleeding. 38…”

Section: Diagnosis Of Portal Hypertension and Cirrhosismentioning

confidence: 99%

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Karuvannur,

Laique,

Radhakrishnan

et al. 2024

Digestive Disease Interventions

View full text Add to dashboard Cite

Portal hypertension is caused by resistance to the portal blood flow, which most commonly occurs in the setting of cirrhosis. Complications of portal hypertension can cause significant morbidity and mortality in the pediatric population. Portal hypertension is diagnosed when the hepatic venous pressure gradient (HVPG) is more than 5 mm Hg, and potential bleeding complications from esophageal and gastric varices are more likely when the HVPG is more than 10 mm Hg. Diagnosis can be made clinically; however, liver biopsy with measurement of the HVPG is ultimately required. The management of portal hypertension in pediatric patients is typically aimed at treatment of the complications. Despite the multiple pharmacologic, endoscopic, surgical, and interventional radiologic management techniques that are available, some pediatric patients will ultimately require liver transplant. Prompt referral is needed in such cases.

show abstract

Section: Diagnosis Of Portal Hypertension and Cirrhosismentioning

confidence: 99%

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Karuvannur,

Laique,

Radhakrishnan

et al. 2024

Digestive Disease Interventions

View full text Add to dashboard Cite

show abstract

“…21 It should be noted that for patients with a suspected intrahepatic cause of PH, the measured transhepatic gradient may not correlate with the degree of PH due to prevalence of veno-venous collaterals in children. 40 41…”

Section: Interventions For Portal Hypertensionmentioning

confidence: 99%

Liver Interventions in Children

Srinviasan,

Acord,

Lambert

et al. 2023

Digestive Disease Interventions

View full text Add to dashboard Cite

This review provides a comprehensive summary of the role of the interventional radiologist in managing liver disorders in children. Interventions are discussed with focus on indications for procedure, technical aspects, and patient management. Recommendations are supported by the most recent evidence and practice experience of the authors in the four subtopics, such as interventions in the post–liver transplant setting, for portal hypertension, for liver tumors, and for vascular anomalies of the liver, with emphasis on congenital portosystemic shunts.

show abstract

“…2,16,17 Unfortunately, the utility of HVPG in children remains limited, mainly due to its invasive nature typically requiring general anesthesia (GA). [18][19][20][21] In adults, HVPG is measured in the setting of "light" sedation, and GA required in children is expected to alter measurements and their prognosis, though in poorly defined ways. Given the preponderance for presinusoidal lesions in children (i.e., biliary atresia [BA]), HVPG may grossly underestimate pressures as it ideally assesses sinusoidal disease.…”

Section: Diagnosis Of Portal Hypertension In Childrenmentioning

confidence: 99%

Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

et al. 2022

View full text Add to dashboard Cite

Complications of cirrhotic portal hypertension (PHTN) in children are broad and include clinical manifestations ranging from variceal hemorrhage, hepatic encephalopathy (HE), ascites, spontaneous bacterial peritonitis (SBP), and hepatorenal syndrome (HRS) to less common conditions such as hepatopulmonary syndrome, portopulmonary hypertension, and cirrhotic cardiomyopathy. The approaches to the diagnosis and management of these complications have become standard of practice in adults with cirrhosis with many guidance statements available. However, there is limited literature on the diagnosis and management of these complications of PHTN in children with much of the current guidance available focused on variceal hemorrhage. The aim of this review is to summarize the current literature in adults who experience these complications of cirrhotic PHTN beyond variceal hemorrhage and present the available literature in children, with a focus on diagnosis, management, and liver transplant decision making in children with cirrhosis who develop ascites, SBP, HRS, HE, and cardiopulmonary complications.

show abstract

Hepatic Venous Pressure Gradient Measurements in Children

Abstract: Objectives: In adults, elevated hepatic venous pressure gradients (HVPG) are correlated with the degree of liver fibrosis on histopathology and predict worse outcomes including variceal bleeding

Cited by 14 publications

References 17 publications

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Pathophysiology, Diagnosis, and Management of Portal Hypertension in the Pediatric Population

Liver Interventions in Children

Beyond Varices: Complications of Cirrhotic Portal Hypertension in Pediatrics

Contact Info

Product

Resources

About