2024
Acute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative (ADQI) and International Club of Ascites (ICA) joint multidisciplinary consensus meeting
Nadim M, Kellum J, Forni L, Francoz C, Asrani S, Ostermann M, Allegretti A, Neyra J, Olson J, Piano S, VanWagner L, Verna E, Akcan-Arikan A, Angeli P, Belcher J, Biggins S, Deep A, Garcia-Tsao G, Genyk Y, Gines P, Kamath P, Kane-Gill S, Kaushik M, Lumlertgul N, Macedo E, Maiwall R, Marciano S, Pichler R, Ronco C, Tandon P, Velez J, Mehta R, Durand F. Acute kidney injury in patients with cirrhosis: Acute Disease Quality Initiative (ADQI) and International Club of Ascites (ICA) joint multidisciplinary consensus meeting. Journal Of Hepatology 2024, 81: 163-183. PMID: 38527522, PMCID: PMC11193657, DOI: 10.1016/j.jhep.2024.03.031.Peer-Reviewed Original ResearchAcute Disease Quality InitiativeInternational Club of AscitesAcute kidney injuryHRS-AKIQuality InitiativeHepatorenal syndromePost-discharge follow-upKidney injuryMultidisciplinary consensus meetingRisk of progression to chronic kidney diseaseProgression to chronic kidney diseasePhenotypes of acute kidney injuryFollow-up of patientsBridge to liver transplantationIncreased in-hospital morbidityIn-hospital morbidityPost-discharge follow-up of patientsChronic kidney diseaseMortality riskConsensus meetingInternational ClubCurative optionSplanchnic vasoconstrictorsAdvanced cirrhosisLiver transplantation
2023
Controversies regarding albumin therapy in cirrhosis.
Trebicka J, Garcia-Tsao G. Controversies regarding albumin therapy in cirrhosis. Hepatology 2023 PMID: 37540192, DOI: 10.1097/hep.0000000000000521.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsSpontaneous bacterial peritonitisBacterial peritonitisAcute kidney injuryLarge-volume paracentesisSerum albumin levelChronic liver diseaseUse of albuminHepatorenal syndromeAdvanced cirrhosisAlbumin infusionKidney injuryAlbumin therapyAlbumin levelsAlbumin useProinflammatory stateLiver diseasePatient selectionVolume overloadPoor outcomeHigh oxidative stressCirrhosisPathophysiological relevanceOxidative stressPeritonitisAlbuminUpdate in the Treatment of the Complications of Cirrhosis
Abraldes J, Caraceni P, Ghabril M, Garcia-Tsao G. Update in the Treatment of the Complications of Cirrhosis. Clinical Gastroenterology And Hepatology 2023, 21: 2100-2109. PMID: 36972759, PMCID: PMC11097249, DOI: 10.1016/j.cgh.2023.03.019.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsTransjugular intrahepatic portosystemic shuntVariceal hemorrhageHepatic encephalopathyPre-emptive transjugular intrahepatic portosystemic shuntsAcute variceal hemorrhageCombination of terlipressinAcute kidney injuryComplications of cirrhosisSecond-line treatmentSignificant portal hypertensionFirst-line treatmentLeast common causePrognosis of patientsOrnithine L-aspartatePresence of varicesIntrahepatic portosystemic shuntStandard of careQuality of lifeCyanoacrylate injectionHepatorenal syndromeUncomplicated ascitesKidney injuryPortal hypertensionRefractory ascitesAlbumin use
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 safetyAscites and its complications
Garcia‐Tsao G. Ascites and its complications. 2022, 522-531. DOI: 10.1002/9781119600527.ch59.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsCirrhotic ascitesPresence of ascitesMainstay of therapySevere liver diseaseSpontaneous bacterial peritonitisAccumulation of fluidHepatorenal syndromePeritoneal malignancyUncomplicated ascitesAbdominal ultrasonographySodium restrictionCirrhotic patientsHepatic hydrothoraxBacterial peritonitisHeart failureLiver diseaseDecompensated stageCommon causePeritoneal cavityAscitesPatientsMost cost-effective methodBacterial infectionsCirrhosisCommon type
2018
Ascites
Garcia‐Tsao G. Ascites. 2018, 127-150. DOI: 10.1002/9781119237662.ch9.Peer-Reviewed Educational MaterialsLarge-volume paracentesesHepatorenal syndromeRefractory ascitesCirrhotic ascitesCommon decompensating eventMassive hepatic metastasesPlasma renin activitySecond-line treatmentFormation of ascitesDevelopment of ascitesCost-effective treatmentSinusoidal hypertensionCardiac indexRenin activityVasodilatory stateHepatic metastasesMalignant ascitesAscites formationCommon precipitantsAscitesHigh mortalityBacterial infectionsHyponatremiaMain predictorsPatients
2016
Approach to the Patient with Ascites and Its Complications
Garcia‐Tsao G. Approach to the Patient with Ascites and Its Complications. 2016, 447-458. DOI: 10.1002/9781118512104.ch55.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsLarge-volume paracentesisSpontaneous bacterial peritonitisNew-onset ascitesPresence of ascitesAcute renal failureFirst-line therapyMainstay of therapySerial large-volume paracentesisEtiology of ascitesAccumulation of fluidHepatorenal syndromePeritoneal malignancyAbdominal ultrasonographyRefractory ascitesSodium restrictionHepatic hydrothoraxLine therapyRenal failureBacterial peritonitisHeart failureDecompensated stageCirrhotic ascitesCommon causePeritoneal cavityAscites
2015
Ascites and Its Complications
Garcia‐Tsao G. Ascites and Its Complications. 2015, 2087-2106. DOI: 10.1002/9781118512074.ch106.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsAcute kidney injuryHepatorenal syndromeCompatible clinical presentationPostliver transplant outcomesCause of ascitesPancreatic ductal systemAccumulation of fluidKidney injuryTransplant outcomesTuberculous peritonitisHeart failureClinical presentationPancreatic ascitesDecompensated stageMalignant ascitesCirrhosisPeritoneal cavityAscitesBetter survivalDuctal systemPatientsPancreatic fluidOptimal managementComplicationsMain causeNatural History of Cirrhosis
Garcia-Tsao G. Natural History of Cirrhosis. 2015, 13-20. DOI: 10.1007/978-3-319-13614-1_2.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPrognostic stageHepatic venous pressure gradientNatural historyDifferent prognostic stagesRecurrent variceal hemorrhageVenous pressure gradientMulti-organ failureAbsence of varicesHepatorenal syndromeDecompensated cirrhosisRefractory ascitesVariceal hemorrhageHepatic encephalopathyLiver failureSpecific complicationsWorse prognosisDecompensated stageReversible diseaseCirrhosisPatientsVaricesPrognosisDecompensationAscitesComplications
2014
Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury
Belcher JM, Sanyal AJ, Peixoto AJ, Perazella MA, Lim J, Thiessen‐Philbrook H, Ansari N, Coca SG, Garcia‐Tsao G, Parikh CR, Consortium F. Kidney biomarkers and differential diagnosis of patients with cirrhosis and acute kidney injury. Hepatology 2014, 60: 622-632. PMID: 24375576, PMCID: PMC4065642, DOI: 10.1002/hep.26980.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-Phase ProteinsAdultAgedAlbuminuriaBiomarkersCreatinineDiagnosis, DifferentialFatty Acid-Binding ProteinsFemaleGlomerular Filtration RateHepatitis A Virus Cellular Receptor 1HumansInterleukin-18KidneyLipocalin-2LipocalinsLiver CirrhosisMaleMembrane GlycoproteinsMiddle AgedProspective StudiesProto-Oncogene ProteinsReceptors, VirusSodiumConceptsAcute kidney injuryAcute tubular necrosisKidney injury molecule-1Neutrophil gelatinase-associated lipocalinHepatorenal syndromePrerenal azotemiaKidney injuryDifferential diagnosisUrinary biomarkersEtiology of AKIProgressive acute kidney injuryLiver-type fatty acidOptimal diagnostic cutoffInjury molecule-1Prospective cohort studyGelatinase-associated lipocalinAccurate differential diagnosisClinical decision makingNumber of biomarkersCohort studyTubular necrosisFractional excretionCommon etiologyInterleukin-18Kidney biomarkers
2011
Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1*
Boyer TD, Sanyal AJ, Garcia‐Tsao G, Regenstein F, Rossaro L, Appenrodt B, Gülberg V, Sigal S, Bexon AS, Teuber P, Group T. Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1*. Liver Transplantation 2011, 17: 1328-1332. PMID: 21837734, PMCID: PMC3760727, DOI: 10.1002/lt.22395.Peer-Reviewed Original ResearchConceptsHepatorenal syndrome type 1Liver transplantationHepatorenal syndromeSyndrome type 1Nontransplant patientsTransplant patientsSurvival benefitSurvival rateType 1Pretransplant renal functionUse of terlipressinClear survival benefitCohort of patientsSurvival of patientsHRS reversalPosttransplant managementLiver transplantPosttransplant survivalMost patientsPosttransplant outcomesRenal functionPoor prognosisTerlipressinPatientsTransplantationAscites
Garcia‐Tsao G. Ascites. 2011, 210-233. DOI: 10.1002/9781444341294.ch10.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsHepatorenal syndromeBacterial infectionsBaseline renal dysfunctionPeripheral arterial vasodilatationAcute kidney injurySecond-line treatmentMainstay of treatmentSpontaneous bacterial peritonitisSympathetic nervous systemEffective blood volumeSpontaneous bacterial infectionsCommon bacterial infectionsSigns of infectionLong-term safetyDiagnostic paracentesisIntravenous albuminPrerenal typeSinusoidal hypertensionAldosterone systemArterial vasodilatationKidney injuryLiver transplantationRefractory ascitesRenal dysfunctionSodium restrictionVasoconstrictor Therapy for Hepatorenal Syndrome
Yeo C, Garcia-Tsao G. Vasoconstrictor Therapy for Hepatorenal Syndrome. Frontiers Of Gastrointestinal Research 2011, 28: 149-162. DOI: 10.1159/000318997.Peer-Reviewed Original ResearchHepatorenal syndromeReceptor agonistClinical trialsEffective arterial blood volumeType 2 hepatorenal syndromeAlpha-adrenergic receptor agonistIschemic adverse eventsNeurohormonal system activationPreferred alternative therapyRenal function effectsFirst-line therapyMain pathogenic mechanismRandomized clinical trialsAdrenergic receptor agonistArterial blood volumeVasopressin receptor agonistSuboptimal study designEase of administrationOral midodrineRenal vasoconstrictionSystemic vasodilatationVasoconstrictor therapyDefinitive therapyIntravenous albuminKidney injury
2008
Acute kidney injury in cirrhosis
Garcia‐Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis. Hepatology 2008, 48: 2064-2077. PMID: 19003880, DOI: 10.1002/hep.22605.Peer-Reviewed Original ResearchConceptsAcute kidney injuryAcute renal failureHepatorenal syndromeKidney injurySerum creatinineSpecific therapyEffective arterial blood volumeUseful bridging therapyAcute tubular necrosisRenal blood flowSpontaneous bacterial peritonitisArterial blood volumeBridging therapyLiver transplantationPrerenal azotemiaRenal dysfunctionRenal failureTubular necrosisBacterial peritonitisVasodilatory stateRelative hypovolemiaVolume repletionCommon causeCirrhosisBlood flowA Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of Terlipressin for Type 1 Hepatorenal Syndrome
Sanyal AJ, Boyer T, Garcia–Tsao G, Regenstein F, Rossaro L, Appenrodt B, Blei A, Gülberg V, Sigal S, Teuber P, Group T. A Randomized, Prospective, Double-Blind, Placebo-Controlled Trial of Terlipressin for Type 1 Hepatorenal Syndrome. Gastroenterology 2008, 134: 1360-1368. PMID: 18471513, PMCID: PMC3730280, DOI: 10.1053/j.gastro.2008.02.014.Peer-Reviewed Original ResearchMeSH KeywordsDose-Response Relationship, DrugDouble-Blind MethodFemaleFollow-Up StudiesGermanyHepatorenal SyndromeHumansInjections, IntravenousKidney Function TestsLypressinMaleMiddle AgedProspective StudiesRussiaSeverity of Illness IndexShock, SepticSurvival RateTerlipressinTreatment OutcomeUnited StatesVasoconstrictor AgentsConceptsHRS type 1Type 1 HRSSCr levelsTreatment successDay 14Type 1Total adverse event rateType 1 hepatorenal syndromePlacebo-controlled clinical trialSafety of terlipressinTrial of terlipressinAdvanced liver diseaseFunctional renal failureNonfatal myocardial infarctionSerum creatinine levelsTransplantation-free survivalAdverse event ratesSyndrome type 1Arterial vasoconstrictorHepatorenal syndromeHRS reversalCreatinine levelsRenal failureRenal functionLiver disease
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
2003
Portal hypertension
GarciaTsao G. Portal hypertension. Current Opinion In Internal Medicine 2003, 2: 229-237. DOI: 10.1097/00132980-200302030-00003.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionHyperdynamic circulationPortosystemic encephalopathyAccumulation of neurotoxinsPortal venous inflowSpontaneous bacterial peritonitisEffective blood volumeExtreme vasodilatationHepatorenal syndromeRenal vasoconstrictionSinusoidal hypertensionVasoconstrictive systemsGastroesophageal varicesIntrahepatic resistanceVariceal hemorrhageHemodynamic abnormalitiesRenal failureBacterial peritonitisCommon complicationHepatic insufficiencySodium retentionVenous inflowMain complicationsNeurohumoral systemsLethal infection
2002
Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis
Ginès P, Uriz J, Calahorra B, Garcia–Tsao G, Kamath PS, Del Arbol LR, Planas R, Bosch J, Arroyo V, Rodés J, Cirrhosis F. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis. Gastroenterology 2002, 123: 1839-1847. PMID: 12454841, DOI: 10.1053/gast.2002.37073.Peer-Reviewed Original ResearchMeSH KeywordsAscitesBacterial InfectionsFemaleGastrointestinal HemorrhageHepatic EncephalopathyHormonesHumansInjections, IntravenousKidneyLiverLiver CirrhosisMaleMiddle AgedParacentesisPeritonitisPortasystemic Shunt, Transjugular IntrahepaticRetreatmentSerum AlbuminSeverity of Illness IndexSurvival AnalysisConceptsTransjugular intrahepatic portosystemic shuntRefractory ascitesParacentesis groupLiver transplantationHepatorenal syndromeTIPS groupTransjugular intrahepatic portosystemic shuntingBlood urea nitrogen levelsChild-Pugh scoreComplications of cirrhosisIntrahepatic portosystemic shuntRecurrence of ascitesSevere hepatic encephalopathyUrea nitrogen levelsIntravenous albuminPrimary endpointSecondary endpointsHepatic encephalopathyPortosystemic shuntingPortosystemic shuntAscites recurrenceParacentesisHealthcare costsAscitesProbability of survival
2001
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Gastroenterology 2001, 17: 281-290. PMID: 17031170, DOI: 10.1097/00001574-200105000-00012.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsPortal hypertensionHyperdynamic circulationPortosystemic encephalopathyAccumulation of neurotoxinsSpontaneous bacterial peritonitisPortal venous inflowEffective blood volumeExtreme vasodilatationHepatorenal syndromeRenal vasoconstrictionSinusoidal hypertensionSplanchnic vasodilatationVasoconstrictive systemsGastroesophageal varicesIntrahepatic resistanceVariceal hemorrhageHemodynamic abnormalitiesRenal failureBacterial peritonitisCommon complicationHepatic insufficiencySodium retentionVenous inflowMain complicationsNeurohumoral systems
2000
Portal hypertension
Garcia-Tsao G. Portal hypertension. Current Opinion In Gastroenterology 2000, 16: 282-289. PMID: 17023887, DOI: 10.1097/00001574-200005000-00012.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsComplications of cirrhosisPortal hypertensionHyperdynamic circulationHepatic insufficiencyCirrhosis portal hypertensionChronic liver diseaseHepatorenal syndromeRenal vasoconstrictionSinusoidal hypertensionGastroesophageal varicesPeripheral vasodilatationHemodynamic abnormalitiesPortosystemic encephalopathyLiver diseaseSodium retentionNeurohumoral systemsHypertensionCirrhosisMajor syndromesVasodilatationComplicationsSyndromeInsufficiencyVaricesVasoconstriction