Portal Hypertension Special Interest Group
Portal Hypertension Special Interest Group
The Portal Hypertension Special Interest Group (SIG) was established to facilitate collaborations in clinical and translational research, and to provide a platform to nurture discussion in best management of patients in this complex and rapidly evolving area. The SIG is linked to Cirrhosis and its Complications CRN topic area.
Portal Hypertension is a very active research area, with recent NIHR HTA funding of two randomised controlled trials which have the potential to become the largest ever clinical trials in cirrhosis. Translational research has been boosted by studies on non-invasive assessment of Portal Hypertension, and exciting new drugs. There is also much debate on the best management of patients with regard to medical and radiological therapies. The SIG lead is Prof Alastair O'Brien of Royal Free Hospital, London. If anyone wishes to join this group please contact the BASL Secretariat at sigs@basl.org.uk
Reflections after EASL 2022
So, a week after BSG and EASL there is much to digest. I was unable to attend BSG but EASL was interesting on so many fronts – some things new, some things borrowed, and some blue (my language on twitter!).
First of all, it was great to see people face to face. I had not quite realised how important that is – there was a genuine sense of joy in seeing colleagues and friends. The cost, sadly, of that has been a definite up-tick in COVID cases amongst gastro and hepatology colleagues, with the inevitable service consequences. How we square these two issues is not easy. There was no mask-wearing at EASL and perhaps more enforcement of these measures may be required.
With respect to portal hypertension, the quality of abstracts was very high – the oral presentations on Saturday afternoon were outstanding. Somatostatin for portal hypertension is a thing (though needs to be proven in clinical trials as opposed to wedge pressure measurements) and nuancing of Baveno guidelines continues.
The stand-out message for me, though, is the rise of the multi-resistant bacteria, such that one is now actively considering the presence of such an organism as being a contraindication to transplantation. The speed with which we have arrived at this situation is worrying – but it was always predicted to be so. A bit like climate change.
BOPP and CALIBRE continue to recruit, along with ASEPTIC. These trials are important. REACT AV will come on stream in the autumn. The BASL meeting will be good – it always is. Please use the opportunity to bring your advanced nurse practitioners, your registrars and FY1s and 2s. The atmosphere is such that is "converts" people to hepatology – it's fun, the dinner is always great, and the science is good.
I will plan another Portal Hypertension SIG meeting in November. I fear the meeting may need to be online again, both for environmental reasons, and flu/COVID reasons – but time will tell. I have also shared information on a portal vein thrombosis meeting being held in Paris in November. The subject is one in which I am interested but that is completely trumped by the venue!
The Paris PVT event is listed here https://www.basl.org.uk/index.cfm/events/list/cid/16/eid/3
Enjoy the summer, and make sure you get a break.
David
Steering Committee
Dr David Patch (Chair), Royal Free Hospital, London
Dr Abhishek Chauhan, University Hospitals Birmingham, Trainee representative
Professor Jonathan Fallowfield, University of Edinburgh
Professor Peter Hayes, University of Edinburgh
Dr Joanna Leithead, Addenbrookes Hospital, Cambridge
Mandy Lomax, Patient representative
Dr Raj Mookerjee, University College London
Professor Dhiraj Tripathi, University Hospitals Birmingham
Dr Vikram Sharma, Royal London Hospital
Professor Adrian Stanley, Glasgow Royal Infirmary
Dr Emmanouil Tsochatzis, University College London
Steering Committee Minutes
Steering Committee meeting - Download BASL Portal Hypertension SIG Steering Committee Meeting Minutes_17.6.20.pdf
Resources and meeting downloads
Updates
BSG Best Practice Guidance
BSG Best Practice Guidance: outpatient management of cirrhosis – part 1: compensated cirrhosis
BSG Best Practice Guidance: outpatient management of cirrhosis – part 2: decompensated cirrhosis
BSG Best Practice Guidance: outpatient management of cirrhosis – part 3: special circumstances
Variceal surveillance
A note from Dr David Patch: Following on from the recent portal hypertension SIG meeting (May 2022), please find a link below to the latest update from the BSG regarding variceal surveillance, and when scoping please bear in mind if patients are potentially candidates for BOPPP or Calibre.
Meeting - 09 May 2022
Please find below the presentations for the meeting:
Session 1: Portal hypertensive bleeding
Download Variceal Bleeding Case_BASL PH SIG_2022 May_Fattah.pdf
Download Variceal bleeding case - reflections on Baveno consensus_BASL PH SIG_2022 May_Lachlan.pdf
REACT-AV study (slides to follow)
Session 2: Drug-resistant infection
Download ACLD with infection_BASL PH SIG_2022 May_Jeyanesan.pdf
Download PROMISE Trial Presentation_BASL PH SIG_2022 May_Shawcross.pdf
Session 3: Ascites
Case - refactory ascites with no options (slides to follow)
Download REDUCe 2 clinical study update_BASL PH SIG_2022 May_Verma.pdf
Session 4: NIHR multicentre studies update
BOPPP (to follow)
Download CALIBRE clinical study update_BASL PH SIG_2022 May_Tripathi.pdf
Download ASEPTIC clinical study update_BASL PH SIG_2022 May_Crocombe.pdf
Meeting - 23 January 2020
Meeting report - Download BASL Portal Hypertension Special Interest Group 2nd Meeting Report 2020.pdf
Guidelines and Guidance
Guidelines Transjugular Intrahepatic Portosystemic Stent-Shunt (TIPSS) in the management of portal hypertension (4/3/20) - https://gut.bmj.com/content/69/7/1173
Guidelines on the Management of Ascites in Cirrhosis - The British Society of Gastroenterology in collaboration with British Association for the Study of the Liver has prepared this document (11/11/20) - Download gutjnl-2020-321790.full_.pdf
Guidance document: risk assessment of patients with cirrhosis prior to elective non-hepatic surgery (13/3/23) - BASL / BSG endorsed and open access. All members of the BASL Portal Hypertension SIG Steering Committee contributed.
View and download the guidance on the BMJ website > Here .
SIG Meeting Recordings 2021
Portal Hypertension SIG meeting - 5th May 2021
View a programme here > Download Portal Hypertension SIG Meeting Prog 5 May 2021 v7.pdf
Watch the meeting by clicking > here.
NB: the presentation by Prof Debbie Shawcross can be viewed as a seperate video by clicking > here .
Portal Hypertension SIG Webinar - Updates on TIPSS for variceal bleeding - 7th July 2021
Programme:
- Moderator: Prof Peter Hayes
- Case presentation: “When is a TIPSS in acute variceal bleeding too late?” Speaker: Dr Dhiraj Tripathi, University Hospitals Birmingham
- Current guidelines and future directions: Speaker: Dr David Patch, Royal Free Hospital, London.
- Service and economic implications: Speaker: Dr Jo Leithead, Forth Valley Royal Hospital, Larbert.
Watch the webinar by clicking > here .
Portal Hypertension SIG Webinar - Updates on TIPSS for Ascites - 17th November 2021
Programme:
- Moderator: Prof Dhiraj Tripathi, University Hospitals Birmingham
- TIPSS for ascites: Optimal patient selection. Speaker: Prof Juan Carlos Garica-Pagan, Hospital Clinic, Barcelona
- Economic evaluation of TIPSS for ascites: Speaker: Prof Guru Aithal, Nottingham Digestive Diseases Centre, Nottingham
- Conclusion by moderator
Watch the webinar by clicking > here .
