Complications of Cirrhosis, An Issue of Clinics in Liver Disease

1st Edition, Volume 25-2 - April 14, 2021
Editors: Andres Cardenas, Thomas Reiberger
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 3 8 7 - 2
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 3 8 8 - 9

In collaboration with Consulting Editor, Dr. Norman Gitlin, Guest Editors Drs. Andres Cardenas and Thomas Reiberger have created an up-to-date monograph on the complications of… Read more

Complications of Cirrhosis, An Issue of Clinics in Liver Disease

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In collaboration with Consulting Editor, Dr. Norman Gitlin, Guest Editors Drs. Andres Cardenas and Thomas Reiberger have created an up-to-date monograph on the complications of cirrhosis. They have secured top experts to contribute clinical review articles on the following topics: Non-invasive Detection of CSPH in cACLD; Prevention of First Decompensation in ACLD; Treatment of Acute Variceal Bleeding in 2020: When to Use TIPS; Prevention of Variceal Bleeding and Rebleeding by NSBB: A Tailored Approach; The Role of Hepatic Venous Pressure Gradient (HVPG); Measurement in the Management of Cirrhosis; Bacterial Infections in Cirrhosis as a Cause or Consequence of Decompensation; Nutrition in Chronic Liver Disease; Diagnosis and Management of Hepatic Encephalopathy; Discriminating Acute Decompensation from Acute-on-Chronic Liver; Management of Severe and Refractory Ascites; Monitoring Renal Function and Therapy of HRS patients with Cirrhosis; Coagulopathy in Cirrhosis; and Current Concepts of Cirrhotic Cardiomyopathy. Hepatologists will come away with the information they need to manage these patients.

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Preface
Noninvasive Detection of Clinically Significant Portal Hypertension in Compensated Advanced Chronic Liver Disease
Key points
Introduction
Laboratory tests and physical signs
Imaging
Liver elastography for the assessment of clinically significant portal hypertension
Liver elastography for the assessment of gastroesophageal varices
Spleen elastography
Combination tests
Summary
Clinics care points
Prevention of First Decompensation in Advanced Chronic Liver Disease
Key points
Importance of preventing first decompensation
Etiologic therapies
Removal of cofactors
Pathophysiology-oriented therapies
Design of trials on the prevention of first decompensation
Clinics care points
Prevention of Variceal Bleeding and Rebleeding by Nonselective Beta-Blockers: A Tailored Approach
Key points
Background
Diagnosis of clinically significant portal hypertension and assessing hemodynamic response to nonselective beta-blocker therapy by measurement of the hepatic venous pressure gradient
Noninvasive diagnosis of clinically significant portal hypertension and dynamic surrogates of hemodynamic response to nonselective beta-blockers
State of the art in primary prophylaxis of variceal bleeding
State of the art in secondary prophylaxis of variceal bleeding
Dose titration and nonselective beta-blocker treatment in patients with ascites
Summary: a tailored approach to nonselective beta-blocker treatment
Outlook: The Viennese approach to hepatic venous pressure gradient-guided nonselective beta-blocker therapy in patients with compensated advanced chronic liver disease
Clinics care points
The Role of Hepatic Venous Pressure Gradient in the Management of Cirrhosis
Key points
Introduction
Measuring portal pressure gradient in clinical practice: the hepatic venous pressure gradient
Applications of hepatic venous pressure gradient in cirrhosis
Summary
Clinics care points
Treatment of Acute Variceal Bleeding in 2021—When to Use Transjugular Intrahepatic Portosystemic Shunts?
Key points
Introduction
Transjugular intrahepatic portosystemic shunts for primary prophylaxis
Acute episode of variceal bleeding
Role of preemptive transjugular intrahepatic portosystemic shunt in patients with variceal bleeding at high risk of treatment failure and of mortality
Transjugular intrahepatic portosystemic shunt in secondary prophylaxis after acute variceal bleeding
Management of gastric varices
Management of ectopic varices
Portal hypertension gastropathy
Clinics care points
Bacterial Infections in Cirrhosis as a Cause or Consequence of Decompensation?
Key points
Introduction
Cirrhosis predisposes to bacterial infections
Bacterial infections as a cause of decompensation
Bacterial infections as a consequence of decompensation
Prevention of infections as a strategy to prevent decompensation and/or further decompensation in cirrhosis
Treatment of infections as a strategy to prevent decompensation and/or further decompensation in cirrhosis
Summary
Clinics care points
Nutritional Evaluation and Treatment of the Cirrhotic Patient
Key points
Nutritional status of the cirrhotic patient
Screening and assessment of malnutrition sarcopenia and frailty
Nutritional and lifestyle support of the cirrhotic patient
Summary
Clinics care points
Case study
Diagnosis and Management of Hepatic Encephalopathy
Key points
Introduction
Summary
Clinics care points
Appendix 1. Useful workup for the diagnosis and differential diagnosis of hepatic encephalopathy
Appendix 2. Pros and cons of measurement of ammonia plasma level
Appendix 3. Animal naming test instructions
Acute Decompensation and Acute-on-Chronic Liver Failure
Key points
Cirrhosis, acute decompensation, and acute-on-chronic liver failure
Definition and pathophysiology of acute decompensation
Precipitants of acute decompensation
Summary
Clinics care points
Management of Severe and Refractory Ascites
Key points
Introduction
Definitions
Pathophysiology
Management and therapeutic options
Summary
Monitoring Renal Function and Therapy of Hepatorenal Syndrome Patients with Cirrhosis
Key points
Acute kidney injury in cirrhosis: relevance of the problem
Definition of acute kidney injury in cirrhosis
Differential diagnosis of acute kidney injury: role of urine biomarkers
Pathophysiology of hepatorenal syndrome
Management of hepatorenal syndrome–acute kidney injury
Prevention
Clinics care points
Invasive Procedures in Patients with Cirrhosis: A Clinical Approach Based on Current Evidence
Key points
Coagulation tests in cirrhosis
Thresholds and bleeding risk
Clinical scenarios
Prophylactic transfusion
Current recommendations based on available evidence
Clinics care points
Current Concepts of Cirrhotic Cardiomyopathy
Key points
Introduction
Epidemiology
Clinics care points
Pathophysiology
Clinics care point
Diagnosis
Clinics care points
Pretransplant implications
Posttransplant implications
Clinics care points
Proposed management
Clinics care points
Future directions
Summary
Supplementary data