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Current Hepatology Reports

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01-09-2017 | Portal Hypertension (J Abraldes and E Tsochatzis, Section Editors)

Risk Stratification with Noninvasive Tools in Patients with Compensated Cirrhosis

Authors: Mònica Pons, Salvador Augustin, Joan Genescà

Published in: Current Hepatology Reports | Issue 3/2017

Abstract

Purpose of Review

The main goal of the present review is to summarize current strategies to predict the presence of clinically significant portal hypertension (CSPH), varices, and decompensation with noninvasive methods, mainly focusing in transient elastography (TE) which is the most validated tool.

Recent Findings

TE has demonstrated to predict the presence of CSPH. Values >20–25 kPa rule in the presence of CSPH with a probability >90%. On the other hand, when combined with platelet count, TE has been shown to rule out the presence of high-risk varices. In fact, patients with compensated advanced chronic liver disease (cACLD) with TE <20 kPa and platelet count >150 × 10⁹/L have a very low risk of having varices needing treatment and endoscopy can be safely avoided. TE also can predict the risk of decompensation especially when repeated measures are performed.

Summary

TE is easy to perform in clinical daily practice and it has been incorporated in clinical guidelines for the management of patients with advanced chronic liver disease. Current evidences and future improvements will greatly reduce the use of invasive procedures in cACLD patients.

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Title: Risk Stratification with Noninvasive Tools in Patients with Compensated Cirrhosis
Authors: Mònica Pons
Salvador Augustin
Joan Genescà
Publication date: 01-09-2017
Publisher: Springer US
Published in: Current Hepatology Reports / Issue 3/2017
Electronic ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-017-0357-7

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