The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus

BACKGROUND: In Australia, chronic liver disease is now the third leading cause of premature death in people aged 50-59 years, and the fourth leading cause in all other 5-year age groups from 35 to 70 years in Australia. A consensus statement on the diagnosis and management of portal hypertension in patients with cirrhosis was developed by the Gastroenterological Society of Australia (GESA), the peak national organization for health care professionals and researchers working in gastroenterology and hepatology, to provide contemporary, evidence-based clinical guidelines. A summary of its recommendations is presented here. METHODS: The consensus statement was developed in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument and the 2016 National Health and Medical Research Council Standards for Guidelines. A panel of 46 health care professionals with expertise in managing portal hypertension participated in the development of the consensus statement. The consensus development conference method was used to determine consensus for each recommendation, with a hybrid face-to-face and online meeting held in Noosa, Australia, on 3 August 2024, followed by 2 online meetings. RESULTS: A total of 52 recommendations were approved by the consensus development group without dissent across the following domains: (1) diagnosis, risk stratification, and prevention of decompensation; (2) portal hypertension-related bleeding; (3) ascites and renal impairment; (4) hepatic encephalopathy; (5) sarcopenia, nutrition, and frailty; (6) thrombosis in cirrhosis; (7) cardiopulmonary complications; (8) surgery and portal hypertension; and (9) pregnancy and portal hypertension. DISCUSSION: This is the first Australian consensus statement on the diagnosis and management of portal hypertension in patients with cirrhosis. The recommendations in this summary document provide standardized clinical guidance with the goal of improving outcomes for patients with cirrhosis and portal hypertension in Australia.

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Journal
Hepatology Communications
Published
2026-03-31
DOI
https://doi.org/10.1097/hc9.0000000000000934
Primary Topic
Liver Disease and Transplantation
Type
article
Field-Weighted Citation Impact
0.00

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article

The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus

Radha Popuri, Adam Testro, Kate Muller, Madeleine Gill et al.
Hepatology Communications
Liver Disease and Transplantation
article

The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus

Radha Popuri, Adam Testro, Kate Muller, Madeleine Gill, Purnima Bhat, Rohit Sawhney, Jeyamani Ramachandran, Golo Ahlenstiel, Adrian Maher, Nishita Jagarlamudi, John Lubel, Ruelan Furtado, Brooke Chapman, Neha Tiwari, Sarah Romero, Lucy Gracen, Penelope Hey, Natasha Janko, Marie J. Sinclair, Cositha Santhakumar, Rohit Gupta, Richard Pow, Fadak Mohammadi, Talal Valliani, Simone Irene Strasser, Rachael Jacob, Jonathan M. Tibballs, Ashok S. Raj, Avik Majumdar, Ammar Majeed, Alexander J. Thompson, Karen Waller, Sarah Walker, Anoop Koshy, Adam Doyle, James A Thomas, Shelley Keating, James Fergusson, William Kemp, Tim Mitchell, Jacinta Holmes, Gerry MacQuillan, Stuart K. Roberts, Stephen Bloom
article en

Abstract

BACKGROUND: In Australia, chronic liver disease is now the third leading cause of premature death in people aged 50-59 years, and the fourth leading cause in all other 5-year age groups from 35 to 70 years in Australia. A consensus statement on the diagnosis and management of portal hypertension in patients with cirrhosis was developed by the Gastroenterological Society of Australia (GESA), the peak national organization for health care professionals and researchers working in gastroenterology and hepatology, to provide contemporary, evidence-based clinical guidelines. A summary of its recommendations is presented here. METHODS: The consensus statement was developed in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument and the 2016 National Health and Medical Research Council Standards for Guidelines. A panel of 46 health care professionals with expertise in managing portal hypertension participated in the development of the consensus statement. The consensus development conference method was used to determine consensus for each recommendation, with a hybrid face-to-face and online meeting held in Noosa, Australia, on 3 August 2024, followed by 2 online meetings. RESULTS: A total of 52 recommendations were approved by the consensus development group without dissent across the following domains: (1) diagnosis, risk stratification, and prevention of decompensation; (2) portal hypertension-related bleeding; (3) ascites and renal impairment; (4) hepatic encephalopathy; (5) sarcopenia, nutrition, and frailty; (6) thrombosis in cirrhosis; (7) cardiopulmonary complications; (8) surgery and portal hypertension; and (9) pregnancy and portal hypertension. DISCUSSION: This is the first Australian consensus statement on the diagnosis and management of portal hypertension in patients with cirrhosis. The recommendations in this summary document provide standardized clinical guidance with the goal of improving outcomes for patients with cirrhosis and portal hypertension in Australia.

Hepatology CommunicationsVol. 10(4)
Griffith University (AU), Australian National University (AU), The University of Sydney (AU), The Royal Melbourne Hospital (AU), The University of Queensland (AU), The University of Melbourne (AU), Flinders University (AU), The University of Western Australia (AU), Sydney Adventist Hospital (AU), Royal Prince Alfred Hospital (AU), Royal Perth Hospital (AU), Concord Repatriation General Hospital (AU), Centenary Institute (AU), Wollongong Hospital (AU), Princess Alexandra Hospital (AU), Sir Charles Gairdner Hospital (AU), Blacktown & Mount Druitt Hospital (AU), Flinders Medical Centre (AU), Canberra Hospital (AU), St Vincent's Hospital Melbourne (AU), Chris O’Brien Lifehouse (AU), Eastern Health (AU), Sunshine Coast University Hospital (AU), Peninsula Health (AU), Sydney Local Health District (AU), Westmead Institute for Medical Research (AU), Mater Adult Hospital (AU), Alfred Health (AU), Austin Health (AU), Monash University (AU), Western Sydney University (AU), Macquarie University (AU)
Gilead Sciences, CSL Behring, Novo Nordisk, Ipsen, Norgine
Openalex Percentile: Top 40%
Liver Disease and Transplantation
DOIOpen Access PDFOpenAlex
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