What are the AASLD recommendations for noninvasive testing in the diagnosis of clinically significant portal hypertension (CSPH)?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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The 2016 American Association for the study of Liver Diseases (AASLD) provides the following guidance for noninvasive testing for the diagnosis of clinically significant portal hypertension (CSPH) [72] :

  • Hepatic venous pressure gradient (HVPG) measurement is the gold-standard method to assess the presence of CSPH, defined as an HVPG of at least 10 mm Hg.
  • CSPH can be identified by noninvasive tests: Liver stiffness above 20-25 kPa, alone or combined with platelet count and spleen size. The presence of portosystemic collaterals on imaging studies is sufficient to diagnose CSPH.
  • By definition, patients with gastroesophageal varices as demonstrated by endoscopy have CSPH.

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