Pharmacologic treatment of portal hypertension: Past, present, and future

Boyer, Thomas D.

doi:10.1053/jhep.2001.27545

Cited by 39 publications

(16 citation statements)

References 45 publications

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“…To prevent EV rupture and to lower portal pressure, some drugs, originally for systemic hypertension, have been on trial. Presently, betablockers and nitrates can be used for this clinical purpose, but there are known limitations in their efficacies and indications [31]. AT1 blockade is expected as a new treatment option for portal hypertension associated with liver cirrhosis [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Expression of angiotensin II type 1 receptor in human cirrhotic livers: Its relation to fibrosis and portal hypertension

Ohsawa

Shirai

Sugama

et al. 2005

Hepatology Research

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Section: Discussionmentioning

confidence: 99%

Expression of angiotensin II type 1 receptor in human cirrhotic livers: Its relation to fibrosis and portal hypertension

Ohsawa

Shirai

Sugama

et al. 2005

Hepatology Research

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“…Endoscopic band ligation is preferable to endoscopic sclerotherapy by reducing recurrent variceal bleeding risk and variceal stricture incidence in poor intolerance or beta-blocker therapy contraindications [113][114][115][116][117] . Furthermore, other authors have revealed that the combination of beta-blockers and endoscopic band ligation is superior to banding ligation alone in prevention of variceal recurrence and refractory bleeding [118][119][120] . If both beta-blocker drugs and endoscopic band ligation failed to prevent recurrent variceal bleeding then the options are distal splenorenal shunt or TIPS considered as bridge procedures for liver transplantation [61,62] .…”

Section: Surgical Treatments Of Refractory Variceal Bleedingmentioning

confidence: 99%

Surgical outcomes of distal splenorenal shunt or liver transplantation in treatment of schistosomal refractory variceal bleeding

Doush¹,

Elzein²

2018

JUMD

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Schistosomiasis is one of the most prevalent neglected tropical diseases, remains a serious public health problem in many developing countries in the tropics and subtropics and its pathogenesis depends on the parasite-host interaction. Periportal fibrosis of schistosomiasis complicated by portal hypertension results from increased intrahepatic vascular resistance and blood flow through the portal venous system. This leads to portosystemic collateral variceal veins formation which dilates until they finally rupture and bleed due to progressive rising in the portal venous pressure. The clinical impact of esophagogastric varices is critical due to the rebleeding rate of esophageal varices remains high within two years after cessation of acute bleeding from medium or large varices. In the present review, we will discuss hepatosplenic schistosomiasis and oesophagogastric varices pathophysiology and review the current surgical outcomes of distal splenorenal shunt or liver transplantation in schistosomal refractory variceal bleeding.

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“…12 mm Hg is achieved, ␤ -blockers can be combined with isosorbide mononitrate [14] . In the case of acute bleeding, terlipressin, a vasopressin analogue, can be used as an effective agent to control variceal bleeding [15] . Vasoactive drugs should be given immediately and maintained for 5 days, and should be combined with initial endoscopic treatment [16] .…”

Section: Options For Treatment Prior To Liver Transplantationmentioning

confidence: 99%

Liver Transplantation as Ultimate Tool to Treat Portal Hypertension

Klupp

Köhler

Pascher

et al. 2005

Dig Dis

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Portal hypertension is a complication of liver cirrhosis that may itself cause complications such as variceal bleeding, ascites and hepatorenal syndrome. There are several options for symptomatic treatment including drug therapy, endoscopy, transjugular intrahepatic portosystemic shunt (TIPS), and various surgical procedures, notably liver transplantation, the only causal treatment. The indication for liver transplantation has to be defined carefully. Progression of the primary disease, evaluation of comorbidity and overall prognosis have to be considered. Conservative symptomatic treatment is used for bridging purposes until liver transplantation can be provided to cure portal hypertension and the underlying primary disease. Careful timing of the transplantation is necessary as well as reorganization of the waiting lists by introducing new priority systems as the Model for End-Stage Liver Disease (MELD) in order to reduce mortality. Furthermore, living donor liver transplantation and split liver transplantation are methods to enlarge the donor pool, and thus accessibility of transplantation to a greater number of patients. This review evaluates the indication of liver transplantation in the treatment of portal hypertension.

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Pharmacologic treatment of portal hypertension: Past, present, and future

Cited by 39 publications

References 45 publications

Expression of angiotensin II type 1 receptor in human cirrhotic livers: Its relation to fibrosis and portal hypertension

Expression of angiotensin II type 1 receptor in human cirrhotic livers: Its relation to fibrosis and portal hypertension

Surgical outcomes of distal splenorenal shunt or liver transplantation in treatment of schistosomal refractory variceal bleeding

Liver Transplantation as Ultimate Tool to Treat Portal Hypertension

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