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      Prediction of improved liver function after balloon-occluded retrograde transvenous obliteration: relation to hepatic vein pressure gradient.

      Journal of Gastroenterology and Hepatology
      Aged, Balloon Occlusion, adverse effects, Biological Markers, blood, Esophageal and Gastric Varices, diagnosis, physiopathology, therapy, Female, Hepatic Encephalopathy, Hepatic Veins, Humans, Japan, Liver, blood supply, metabolism, Liver Function Tests, Male, Middle Aged, Oleic Acids, administration & dosage, Prothrombin, Recovery of Function, Sclerosing Solutions, Sclerotherapy, Serum Albumin, Time Factors, Treatment Outcome, Venous Pressure

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          Abstract

          Balloon-occluded retrograde transvenous obliteration (B-RTO) is an effective treatment for gastric varices (GVx), as well as hepatic encephalopathy. The aim of this study was to examine the changes of the hepatic vein pressure gradient (HVPG) after B-RTO and determine the relation between the changes of HVPG and liver function. B-RTO was performed in 30 patients with GVx and hepatic encephalopathy. HVPG was measured in 19 of 30 patients both before and after B-RTO. The B-RTO was successful in all patients. The GVx and hepatic encephalopathy were improved, and no recurrence or bleeding was observed within the follow- up period. The serum albumin and prothrombin activity were significantly improved 6 months after B-RTO in all patients. HVPG was elevated 44% above the baseline after B-RTO. Liver function significantly improved 6 months after B-RTO in patients whose HVPG increased ≥ 20% from baseline. An elevated HVPG after B-RTO is one aspect of the effect of liver function, and an HVPG increase of ≥ 20% from baseline is a predictive factor for obtaining an improvement of liver function. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

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