2022
Safety, Tolerability, Pharmacokinetics, and Efficacy of Terlipressin Delivered by Continuous Intravenous Infusion in Patients with Cirrhosis and Refractory Ascites
Bajaj J, Fischer J, Yeramian P, Gavis E, Fagan A, Angeli P, Garcia-Tsao G, Adams J, Markham P. Safety, Tolerability, Pharmacokinetics, and Efficacy of Terlipressin Delivered by Continuous Intravenous Infusion in Patients with Cirrhosis and Refractory Ascites. GastroHep 2022, 2022: 1-8. DOI: 10.1155/2022/5065478.Peer-Reviewed Original ResearchLarge-volume paracentesesRefractory ascitesContinuous intravenous infusionIntravenous infusionAverage steady-state plasma concentrationTreatment-related adverse eventsSteady-state plasma concentrationsML/min/Efficacy of terlipressinInfusion of terlipressinSafety/tolerabilityAdvanced liver cirrhosisPhase 2a trialVolume of ascitesVolume of distributionState plasma concentrationsHepatorenal syndromeVariceal bleedingCirrhotic patientsInpatient periodAdverse eventsLiver cirrhosisIV infusionRelated complicationsAcceptable safety
2019
Gastroesophageal Variceal Bleeding Management
Zanetto A, Garcia-Tsao G. Gastroesophageal Variceal Bleeding Management. 2019, 39-66. DOI: 10.1007/978-3-030-24490-3_4.Peer-Reviewed Educational MaterialsGastroesophageal variceal bleedingVariceal bleedingLast decades survivalGeneral medical careMost recent seriesDecades survivalDecompensated patientsLiver transplantationBleeding managementDecompensated stageEffective treatmentClinical practiceMedical careMajor causeMultidisciplinary approachCirrhosisBleedingPatientsMortalityDeathRecent seriesHepatologistsTransplantationCare
2018
Esophageal Varices
Jakab S, Garcia-Tsao G. Esophageal Varices. 2018, 195-208. DOI: 10.1007/978-3-319-98506-0_15.Peer-Reviewed Educational MaterialsVariceal hemorrhageEsophageal varicesComplications of cirrhosisEsophageal variceal hemorrhageScreening/surveillanceSecondary prophylaxisVariceal bleedingLiver diseaseTreatment optionsCurrent recommendationsHigh riskCirrhosisPrevention strategiesVaricesComplicationsHemorrhagePatientsProphylaxisBleedingMortalityDiseaseEVHProgressionSeverity
2017
Stratifying risk in the prevention of recurrent variceal hemorrhage: Results of an individual patient meta‐analysis
Albillos A, Zamora J, Martínez J, Arroyo D, Ahmad I, De‐la‐Peña J, Garcia‐Pagán J, Lo G, Sarin S, Sharma B, Abraldes JG, Bosch J, Garcia‐Tsao G, Cooperation O. Stratifying risk in the prevention of recurrent variceal hemorrhage: Results of an individual patient meta‐analysis. Hepatology 2017, 66: 1219-1231. PMID: 28543862, PMCID: PMC5605404, DOI: 10.1002/hep.29267.Peer-Reviewed Original ResearchConceptsChild B/CPrevious variceal bleedingCombination therapyVariceal bleedingCirrhosis severityChild APrognostic stageRecurrent variceal hemorrhageAdvanced liver failureEndoscopic variceal ligationOutcome of therapyVariceal hemorrhageLiver failureVariceal ligationLiver functionPatientsPatient careVaricealTherapyPatient dataMortalityTrialsCirrhosisBleedingProphylaxisPrimary and secondary prophylaxis of esophageal variceal bleeding
Jangouk P, Garcia-Tsao G. Primary and secondary prophylaxis of esophageal variceal bleeding. Techniques And Innovations In Gastrointestinal Endoscopy 2017, 19: 84-89. DOI: 10.1016/j.tgie.2017.03.004.Peer-Reviewed Educational MaterialsHepatic venous pressure gradientPortal hypertensionVariceal hemorrhageHigh riskComplications of cirrhosisSignificant portal hypertensionVenous pressure gradientDevelopment of varicesEsophageal variceal bleedingIsolated complicationSecondary prophylaxisCompensated cirrhosisDirect complicationsVariceal bleedingClinical decompensationPortal pressureEsophageal varicesCompensated stageChronic conditionsCirrhosisVaricesComplicationsHemorrhageDecompensationPatients
2016
Effect of Current Therapies Aimed at Preventing Variceal Rebleeding on Other Complications of Cirrhosis
Ripoll C, Augustin S, Reiberger T, Moreau R, Salerno F, Albillos A, Abraldes J, Garcia-Tsao G. Effect of Current Therapies Aimed at Preventing Variceal Rebleeding on Other Complications of Cirrhosis. 2016, 333-339. DOI: 10.1007/978-3-319-23018-4_33.Peer-Reviewed Original ResearchComplications of cirrhosisNon-bleeding complicationsNonselective beta blockersBeta blockersLower incidenceSecondary prophylaxisHepatic encephalopathyHepatocellular carcinomaBeneficial effectsLower dysfunction rateNon-hemodynamic effectsDysfunction rateVariceal bleedingCurrent therapiesCovered stentsHemodynamic responseBetter survivalComplicationsCirrhosisBlockersProphylaxisAscitesEarly TIPSIncidencePatientsImpact of Treatment of Non-bleeding Complications of Cirrhosis on the Risk of Variceal Bleeding
Augustin S, Albillos A, Ripoll C, Abraldes J, Salerno F, Moreau R, Reiberger T, Garcia-Tsao G. Impact of Treatment of Non-bleeding Complications of Cirrhosis on the Risk of Variceal Bleeding. 2016, 341-353. DOI: 10.1007/978-3-319-23018-4_34.Peer-Reviewed Original ResearchHepatic venous pressure gradientVariceal hemorrhageVariceal bleedingPortal pressureAlpha-1 adrenergic antagonistNon-bleeding complicationsVenous pressure gradientPortal blood flowClinical trial recordsImpact of treatmentDecompensated cirrhosisOral anticoagulantsRefractory ascitesCirrhotic patientsClinical decompensationCohort studyArterial pressureVasoactive drugsRandomized trialsLarge trialsCardiac outputProphylactic useAdrenergic antagonistsClinical dataBlood flowSecondary Prophylaxis in Special Patient Populations
Reiberger T, Moreau R, Ripoll C, Albillos A, Augustin S, Salerno F, Abraldes J, Garcia-Tsao G. Secondary Prophylaxis in Special Patient Populations. 2016, 317-332. DOI: 10.1007/978-3-319-23018-4_32.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSecondary prophylaxisRefractory ascitesVariceal bleedingSurvival benefitClinical nonrespondersClear precipitating eventProphylaxis of varicealBeta-blocker therapyBeta-blocker treatmentEndoscopic band ligationSpecial patient populationsAdvanced cirrhosisNSBB therapyVariceal rebleedingArterial hypotensionCirrhotic patientsFurther decompensationSerum creatinineBand ligationPatient populationProphylaxisHigh riskCurrent evidencePatientsAscitesIssues in Trial Design and Areas Needing Further Research
Abraldes J, Salerno F, Augustin S, Ripoll C, Reiberger T, Moreau R, Albillos A, Garcia-Tsao G. Issues in Trial Design and Areas Needing Further Research. 2016, 355-363. DOI: 10.1007/978-3-319-23018-4_35.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPrimary end pointVariceal bleedingEnd pointTrial designAppropriate primary end pointVariceal bleeding episodesComplications of cirrhosisNew therapeutic approachesBleeding episodesMultiple complicationsTherapeutic trialsCase mortalityTherapeutic approachesHigh riskLower riskPatientsClinical scenariosComplicationsBleedingPrevious trialsCirrhosisSecond complicationMortalityTrialsDeath
2009
Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis
Qamar AA, Grace ND, Groszmann RJ, Garcia–Tsao G, Bosch J, Burroughs AK, Ripoll C, Maurer R, Planas R, Escorsell A, Garcia–Pagan J, Patch D, Matloff DS, Makuch R, Rendon G, Group P. Incidence, Prevalence, and Clinical Significance of Abnormal Hematologic Indices in Compensated Cirrhosis. Clinical Gastroenterology And Hepatology 2009, 7: 689-695. PMID: 19281860, PMCID: PMC4545534, DOI: 10.1016/j.cgh.2009.02.021.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientHematologic indicesCompensated cirrhosisBaseline hepatic venous pressure gradientWhite blood cell countChild-Pugh scorePredictors of deathPrimary end pointVenous pressure gradientDevelopment of varicesKaplan-Meier analysisBlood cell countCombination of leukopeniaBaseline thrombocytopeniaVariceal bleedingClinical decompensationEsophageal varicesPrognostic significanceTransplant surgeryClinical significanceLeukopeniaThrombocytopeniaCirrhosisCell countVarices
2006
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Internal Medicine 2006, 5: 399-407. DOI: 10.1097/01.mog.0000218962.93806.9a.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionVariceal bleedingTransjugular intrahepatic portosystemic shuntRecurrent variceal bleedingLarge-volume paracentesisSpontaneous bacterial peritonitisEndoscopic variceal ligationIntrahepatic portosystemic shuntHepatorenal syndromeRefractory ascitesBacterial peritonitisVariceal ligationSpecific complicationsPortosystemic shuntHypertensionΒ-blockersComplicationsTrialsBleedingVaricesAscitesDiagnosisRecent findingsRecent studiesCirrhosis
2005
Methotrexate (MTX) plus ursodeoxycholic acid (UDCA) in the treatment of primary biliary cirrhosis
Combes B, Emerson SS, Flye NL, Munoz SJ, Luketic VA, Mayo MJ, McCashland TM, Zetterman RK, Peters MG, Di Bisceglie AM, Benner KG, Kowdley KV, Carithers RL, Rosoff L, Garcia‐Tsao G, Boyer JL, Boyer TD, Martinez EJ, Bass NM, Lake JR, Barnes DS, Bonacini M, Lindsay KL, Mills AS, Markin RS, Rubin R, West AB, Wheeler DE, Contos MJ, Hofmann AF. Methotrexate (MTX) plus ursodeoxycholic acid (UDCA) in the treatment of primary biliary cirrhosis. Hepatology 2005, 42: 1184-1193. PMID: 16250039, DOI: 10.1002/hep.20897.Peer-Reviewed Original ResearchConceptsPrimary biliary cirrhosisUrsodeoxycholic acidVariceal bleedingBiliary cirrhosisTreatment failureSerum bilirubinHistological stagingCourse of PBCM2 body surface areaData Safety Monitoring BoardAMA-positive patientsReasons of futilityFailure of treatmentDevelopment of ascitesBody surface areaSafety monitoring boardEffect of methotrexateLiver transplantationPositive patientsMulticenter trialMedian periodMedian timeHistological progressionMonitoring boardDrug toxicity
2004
Treatment of acute variceal bleeding: general management and prevention of infections
Garcia-Tsao G. Treatment of acute variceal bleeding: general management and prevention of infections. 2004, 233-240. DOI: 10.1007/978-94-007-1042-9_25.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsVariceal bleedingCirrhotic patientsPoor outcomePredictive factorsHepatic venous pressure gradientUpper gastrointestinal bleeding episodesActive variceal bleedingEarly recurrent bleedingAcute variceal bleedingVenous pressure gradientGastrointestinal bleeding episodesPrevention of infectionAlcoholic etiologyBleeding episodesGastrointestinal hemorrhageRecurrent bleedingRenal dysfunctionVariceal hemorrhageLiver dysfunctionEsophageal varicesUncontrolled bleedingDiagnostic endoscopyHepatocellular carcinomaBleedingPatients
2001
Propranolol for the prevention of first esophageal variceal hemorrhage: A lifetime commitment?
Abraczinskas D, Ookubo R, Grace N, Groszmann R, Bosch J, Garcia‐Tsao G, Richardson C, Matloff D, Rodés J, Conn H. Propranolol for the prevention of first esophageal variceal hemorrhage: A lifetime commitment? Hepatology 2001, 34: 1096-1102. PMID: 11731997, DOI: 10.1053/jhep.2001.29305.Peer-Reviewed Original ResearchConceptsVariceal hemorrhageBeta blockersVariceal bleedingPrimary preventionFirst esophageal variceal hemorrhageWithdrawal of propranololOutcomes of patientsPlacebo-controlled trialEsophageal variceal hemorrhageGroup of patientsOriginal study populationUntreated populationBlocker therapyIndefinite administrationPlacebo groupPortal hypertensionProphylactic therapyProspective studyCumulative survivalProtective effectStudy populationHemorrhagePatientsPropranololBlockers
2000
Liver Disease in Patients with Hereditary Hemorrhagic Telangiectasia
Garcia-Tsao G, Korzenik J, Young L, Henderson K, Jain D, Byrd B, Pollak J, White R. Liver Disease in Patients with Hereditary Hemorrhagic Telangiectasia. New England Journal Of Medicine 2000, 343: 931-936. PMID: 11006369, DOI: 10.1056/nejm200009283431305.Peer-Reviewed Original ResearchConceptsHereditary hemorrhagic telangiectasiaHigh-output heart failureHemorrhagic telangiectasiaHeart failureMedian periodPortal hypertensionLiver involvementClinical findingsBiliary diseasePulmonary capillary wedge pressureElevated alkaline phosphatase levelsHepatic sinusoidal pressureSymptomatic liver involvementTypical clinical presentationAlkaline phosphatase levelsAutosomal dominant disorderHyperdynamic circulationAngiodysplastic lesionsCardiac indexLiver transplantationVariceal bleedingWedge pressureMedical therapyRendu-OslerClinical presentation
1995
Variceal Hemorrhage
Navarro V, Garcia-Tsao G. Variceal Hemorrhage. Critical Care Clinics 1995, 11: 391-414. PMID: 7788538, DOI: 10.1016/s0749-0704(18)30073-3.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsVariceal bleedingVariceal hemorrhageFirst variceal bleedingHigh recurrence ratePortal hypertensionBalloon tamponadePharmacologic therapyPortal pressureShunt surgeryActive hemorrhageRecurrence rateBlood flowTherapeutic avenuesHigh mortalityHemorrhageBleedingPreventionHypertensionTamponadeSclerotherapyComplicationsSurgeryRelative effectivenessTherapyMortality
1991
Idiopathic portal hypertension.
Orozco H, Takahashi T, García-Tsao G, Mercado M, Diliz H, Hernández-Ortiz J. Idiopathic portal hypertension. Revista De Investigación Clínica 1991, 43: 80-6. PMID: 1866503.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsIdiopathic portal hypertensionPortal hypertensionHigh re-bleeding rateMain histopathologic findingsNoncirrhotic portal fibrosisObliterative portal venopathySmall portal veinsRe-bleeding rateIntra-abdominal infectionsLong-term prognosisUpper gastrointestinal tractHepatitis B virusEsophago-gastric varicesChronic sclerotherapyHepatoportal sclerosisIPH patientsPortal venopathyPharmacologic managementVariceal bleedingCirrhotic patientsImmunologic abnormalitiesPortal fibrosisLiver failurePeriportal fibrosisSuch patients
1990
Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage
Groszmann R, Bosch J, Grace N, Conn H, Garcia-Tsao G, Navasa M, Alberts J, Rodes J, Fischer R, Bermann M, Rofe S, Patrick M, Lerner E. Hemodynamic events in a prospective randomized trial of propranolol versus placebo in the prevention of a first variceal hemorrhage. Gastroenterology 1990, 99: 1401-1407. PMID: 2210246, DOI: 10.1016/0016-5085(90)91168-6.Peer-Reviewed Original ResearchConceptsHepatic venous pressure gradientVenous pressure gradientVariceal hemorrhageEsophageal varicesHemodynamic eventsBaseline valuesHeart rateFirst variceal hemorrhagePropranolol-treated groupPropranolol-treated patientsTrial of propranololAdministration of propranololBeginning of therapyRate of survivalPortal hypertensionVariceal bleedingCirrhotic patientsPharmacological therapyVariceal sizeProtective effectMortality ratePatientsPlaceboPropranololVaricesRole of the distal splenorenal shunt in management of variceal bleeding in Latin America
Orozco H, Mercado M, Takahashi T, García-Tsao G, Guevara L, Ortíz J, Hernández-Cendejas A, Tielve M. Role of the distal splenorenal shunt in management of variceal bleeding in Latin America. The American Journal Of Surgery 1990, 160: 86-89. PMID: 2368881, DOI: 10.1016/s0002-9610(05)80874-8.Peer-Reviewed Original ResearchConceptsSelective shuntWarren shuntPortal hypertensionSplenorenal shuntDistal splenorenal shuntNormal liver functionTreatment of choiceSplenocaval shuntOperative mortalityVariceal bleedingShunt thrombosisVenous diameterLiver functionShuntChild classHypertensionThrombosisPatientsTreatmentYearsRegular basisLatin American countriesBleedingSchistosomiasisMortality
1989
Association of transdermal nitroglycerin to vasopressin infusion in the treatment of variceal hemorrhage: A placebo‐controlled clinical trial
Bosch J, Groszmann R, García‐Pagán J, Terés J, García‐Tsao G, Navasa M, Mas A, Rodés J. Association of transdermal nitroglycerin to vasopressin infusion in the treatment of variceal hemorrhage: A placebo‐controlled clinical trial. Hepatology 1989, 10: 962-968. PMID: 2511136, DOI: 10.1002/hep.1840100612.Peer-Reviewed Original ResearchConceptsTransdermal nitroglycerinVariceal hemorrhageVariceal bleedingPlacebo-controlled clinical trialActive variceal bleedingEffectiveness of vasopressinDouble-blind techniqueSlow-release preparationHospital mortalityTransfusion requirementsRecurrent bleedingBalloon tamponadeCirrhotic patientsEmergency surgeryVasopressin infusionClinical trialsDefinitive controlDrug combinationsTotal doseNitroglycerinBleedingHemorrhagePatientsInitial controlVasopressin