Hepatic hemodynamics in 24 patients with nodular regenerative hyperplasia and symptomatic portal hypertension

Journal of Gastroenterology and Hepatology
Julien BissonnetteGilles Pomier-Layrargues

Abstract

To evaluate hepatic hemodynamics in patients with nodular regenerative hyperplasia of the liver (NRH) with portal hypertension (PHT). We retrospectively reviewed the charts of 24 patients referred for PHT related to biopsy-proven NRH. Hemodynamic measurements included wedged hepatic vein (WHVP) and inferior vena cava (IVCP), and, in 12 patients, portal vein pressure (PVP). Hepatic vein pressure gradient (HVPG: WHVP-IVCP) and portal vein pressure gradient (PVPG: PVP-IVCP) were calculated. Nodular regenerative hyperplasia was associated in 24 patients with various diseases (oxaliplatin chemotherapy, treatment with purine antagonists, post liver transplantation, hematologic and rheumatologic conditions and HIV infection). Liver function parameters were either completely normal or slightly impaired. Patients were referred for gastroesophageal varices (n = 18), and/or ascites (n = 11), and/or splenomegaly (n = 20). In patients with varices or ascites, HVPG was lower than 10 mmHg (a cut-off point for the presence of varices and/or ascites) in 15/21, suggesting a pre-sinusoidal component to their PHT confirmed by a PVP higher than 12 mmHg in 12/12 patients. The mean difference between HVPG and PVPG was 8.7 mmHg in these patients. Ten ...Continue Reading

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Citations

Jul 25, 2012·Journal of Gastroenterology and Hepatology·Ajay Duseja, Yogesh Chawla
Feb 13, 2016·Liver International : Official Journal of the International Association for the Study of the Liver·Laure Elkrief, Pierre-Emmanuel Rautou
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Aug 28, 2013·Journal of Hepatology·Rajeev Khanna, Shiv K Sarin
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Oct 28, 2015·Clinical Liver Disease·David Semela

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