Table Info

Table 2.

Tabular comparison if ascites infusion protocols in patients with decompensated cirrhosis

Name	Year	Country	Study population	Design	Dose	Patients number	Duration	Results
ANSWER [54]	2018	Italy	Uncomplicated ascites with diuretics	Randomized, multicentric, placebo-controlled, open-label	Standard medical treatment (SMT) or SMT plus HA (40 g twice weekly for 2 weeks, and then 40 g weekly)	Albumin: 218 SMT: 213	18 months	Survival at EOT: Albumin = 77% Control = 66% p = 0.028
MACHT [55]	2018	Spain	Patients with ascites on liver transplantation waiting list	Randomized, multicentric, placebo-controlled, open-label	Albumin (40 g every 2 weeks) + midodrine (15–30 mg/day) vs. placebo	Albumin: 87 Placebo: 86	12 months	No difference in survival or side effects
ATTIRE [57]	2021	UK	Hospitalized patients with decompensated cirrhosis who had a serum albumin level of less than 30 g per liter at enrollment	Randomized, multicenter, open-label, parallel-group trial	Targeted albumin solution (for serum albumin > 30 g/L) for up to 14 days or until discharge, vs. SMT	Albumin: 380 SMT: 397	15 days	No difference in a composite criterion (infection, survival, kidney dysfunction) but more side effects in albumin arm
Di Pascoli et al. [56]	2019	Italy	Patients with refractory cirrhosis	Single-centre, non-randomized open trial	Albumin 40 g per weak vs. SMT	Albumin: 45 SMT: 25	24 months	Reduction in mortality (p = 0.032), in hospitalization (p = 0.008)
PRECIOSA study (NCT03451292)	In progress	Worldwide	Patients with decompensated cirrhosis	Randomized, multicentric, placebo-controlled, open-label	Albumin 1.5 g/kg for 10 days vs. SMT	410 patients	1 year	Active, not recruiting

EOT: end of treatment

Declarations

Acknowledgments

We thank Sarah Legrand-Demai for her English language review and Céline Rigaud for her precious help.

Author contributions

PC: Conceptualization, Writing—original draft, Writing—review & editing. VLR and MDG: Validation, Writing—review & editing. LE: Validation, Writing—review & editing, Supervision.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

References

Carrier P, Jacques J, Debette-Gratien M, Legros R, Sarabi M, Vidal E, et al. Non-cirrhotic ascites: pathophysiology, diagnosis and etiology. Rev Med Interne. 2014;35:365–71. French. [DOI] [PubMed]

European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69:406–60. [DOI] [PubMed]

Moore KP, Wong F, Gines P, Bernardi M, Ochs A, Salerno F, et al. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology. 2003;38:258–66. [DOI] [PubMed]

Arroyo V, Ginès P, Gerbes AL, Dudley FJ, Gentilini P, Laffi G, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. Hepatology. 1996;23:164–76. [DOI] [PubMed]

Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med. 1992;117:215–20. [DOI] [PubMed]

D’Amico G, Morabito A, D’Amico M, Pasta L, Malizia G, Rebora P, et al. Clinical states of cirrhosis and competing risks. J Hepatol. 2018;68:563–76. [DOI] [PubMed]

Llach J, Ginès P, Arroyo V, Rimola A, Titó L, Badalamenti S, et al. Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites. Gastroenterology. 1988;94:482–7. [DOI] [PubMed]

Bruno S, Saibeni S, Bagnardi V, Vandelli C, De Luca M, Felder M, et al.; AISF (Italian Association for the Study of the Liver) – EPA-SCO Collaborative Study Group. Mortality risk according to different clinical characteristics of first episode of liver decompensation in cirrhotic patients: a nationwide, prospective, 3-year follow-up study in Italy. Am J Gastroenterol. 2013;108:1112–22. [DOI] [PubMed]

Bureau C, Thabut D, Oberti F, Dharancy S, Carbonell N, Bouvier A, et al. Transjugular Intrahepatic Portosystemic Shunts With Covered Stents Increase Transplant-Free Survival of Patients With Cirrhosis and Recurrent Ascites. Gastroenterology. 2017;152:157–63. [DOI] [PubMed]

10.

Ginés P, Quintero E, Arroyo V, Terés J, Bruguera M, Rimola A, et al. Compensated cirrhosis: natural history and prognostic factors. Hepatology. 1987;7:122–8. [DOI] [PubMed]

11.

Kanwal F, Nelson R, Liu Y, Kramer JR, Hernaez R, Cholankeril G, et al. Cost of Care for Patients With Cirrhosis. Am J Gastroenterol. 2024;119:497–504. [DOI] [PubMed]

12.

Bernardi M, Moreau R, Angeli P, Schnabl B, Arroyo V. Mechanisms of decompensation and organ failure in cirrhosis: From peripheral arterial vasodilation to systemic inflammation hypothesis. J Hepatol. 2015;63:1272–84. [DOI] [PubMed]

13.

Arroyo V, Terra C, Ruiz-del-Arbol L. Pathogenesis, Diagnosis and Treatment of Ascites in Cirrhosis. In: Rodés J, Benhamou JP, Blei AT, Reichen J, Rizzetto M, editors. Textbook of Hepatology. John Wiley & Sons, Ltd; 2007. pp. 666–710. [DOI]

14.

Schrier RW, Arroyo V, Bernardi M, Epstein M, Henriksen JH, Rodés J. Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis. Hepatology. 1988;8:1151–7. [DOI] [PubMed]

15.

Angeli P, Wong F, Watson H, Ginès P; CAPPS Investigators. Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology. 2006;44:1535–42. [DOI] [PubMed]

16.

Wiese S, Hove JD, Bendtsen F, Møller S. Cirrhotic cardiomyopathy: pathogenesis and clinical relevance. Nat Rev Gastroenterol Hepatol. 2014;11:177–86. [DOI] [PubMed]

17.

Jalan R, D’Amico G, Trebicka J, Moreau R, Angeli P, Arroyo V. New clinical and pathophysiological perspectives defining the trajectory of cirrhosis. J Hepatol. 2021;75:S14–26. [DOI] [PubMed]

18.

Bernardi M, Caraceni P, Navickis RJ, Wilkes MM. Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials. Hepatology. 2012;55:1172–81. [DOI] [PubMed]

19.

Ruiz-del-Arbol L, Monescillo A, Jimenéz W, Garcia-Plaza A, Arroyo V, Rodés J. Paracentesis-induced circulatory dysfunction: mechanism and effect on hepatic hemodynamics in cirrhosis. Gastroenterology. 1997;113:579–86. [DOI] [PubMed]

20.

Ginès P, Titó L, Arroyo V, Planas R, Panés J, Viver J, et al. Randomized comparative study of therapeutic paracentesis with and without intravenous albumin in cirrhosis. Gastroenterology. 1988;94:1493–502. [DOI] [PubMed]

21.

Ginès A, Fernández-Esparrach G, Monescillo A, Vila C, Domènech E, Abecasis R, et al. Randomized trial comparing albumin, dextran 70, and polygeline in cirrhotic patients with ascites treated by paracentesis. Gastroenterology. 1996;111:1002–10. [DOI] [PubMed]

22.

Biggins SW, Angeli P, Garcia-Tsao G, Ginès P, Ling SC, Nadim MK, et al. Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome: 2021 Practice Guidance by the American Association for the Study of Liver Diseases. Hepatology. 2021;74:1014–48. [DOI] [PubMed]

23.

Adebayo D, Neong SF, Wong F. Refractory Ascites in Liver Cirrhosis. Am J Gastroenterol. 2019;114:40–7. [DOI] [PubMed]

24.

Tan HK, James PD, Wong F. Albumin May Prevent the Morbidity of Paracentesis-Induced Circulatory Dysfunction in Cirrhosis and Refractory Ascites: A Pilot Study. Dig Dis Sci. 2016;61:3084–92. [DOI] [PubMed]

25.

Bernardi M, Angeli P, Claria J, Moreau R, Gines P, Jalan R, et al. Albumin in decompensated cirrhosis: new concepts and perspectives. Gut. 2020;69:1127–38. [DOI] [PubMed] [PMC]

26.

De Gottardi A, Thévenot T, Spahr L, Morard I, Bresson-Hadni S, Torres F, et al. Risk of complications after abdominal paracentesis in cirrhotic patients: a prospective study. Clin Gastroenterol Hepatol. 2009;7:906–9. [DOI] [PubMed]

27.

Wong F. Innovative approaches to the management of ascites in cirrhosis. JHEP Rep. 2023;5:100749. [DOI] [PubMed] [PMC]

28.

Wang Q, Zhao H, Deng Y, Zheng H, Xiang H, Nan Y, et al. Validation of Baveno VII criteria for recompensation in entecavir-treated patients with hepatitis B-related decompensated cirrhosis. J Hepatol. 2022;77:1564–72. [DOI] [PubMed]

29.

Hofer BS, Simbrunner B, Hartl L, Jachs M, Balcar L, Paternostro R, et al. Hepatic recompensation according to Baveno VII criteria is linked to a significant survival benefit in decompensated alcohol-related cirrhosis. Liver Int. 2023;43:2220–31. [DOI] [PubMed]

30.

Bernardi M, Santini C, Trevisani F, Baraldini M, Ligabue A, Gasbarrini G. Renal function impairment induced by change in posture in patients with cirrhosis and ascites. Gut. 1985;26:629–35. [DOI] [PubMed] [PMC]

31.

Ring-Larsen H, Henriksen JH, Wilken C, Clausen J, Pals H, Christensen NJ. Diuretic treatment in decompensated cirrhosis and congestive heart failure: effect of posture. Br Med J (Clin Res Ed). 1986;292:1351–3. [DOI] [PubMed] [PMC]

32.

Bernardi M, Laffi G, Salvagnini M, Azzena G, Bonato S, Marra F, et al. Efficacy and safety of the stepped care medical treatment of ascites in liver cirrhosis: a randomized controlled clinical trial comparing two diets with different sodium content. Liver. 1993;13:156–62. [DOI] [PubMed]

33.

Pockros PJ, Reynolds TB. Rapid diuresis in patients with ascites from chronic liver disease: the importance of peripheral edema. Gastroenterology. 1986;90:1827–33. [DOI] [PubMed]

34.

Runyon BA; AASLD Practice Guidelines Committee. Management of adult patients with ascites due to cirrhosis: an update. Hepatology. 2009;49:2087–107. [DOI] [PubMed]

35.

Bernardi M, Servadei D, Trevisani F, Rusticali AG, Gasbarrini G. Importance of plasma aldosterone concentration on the natriuretic effect of spironolactone in patients with liver cirrhosis and ascites. Digestion. 1985;31:189–93. [DOI] [PubMed]

36.

Gatta A, Angeli P, Caregaro L, Menon F, Sacerdoti D, Merkel C. A pathophysiological interpretation of unresponsiveness to spironolactone in a stepped-care approach to the diuretic treatment of ascites in nonazotemic cirrhotic patients. Hepatology. 1991;14:231–6. [PubMed]

37.

Santos J, Planas R, Pardo A, Durández R, Cabré E, Morillas RM, et al. Spironolactone alone or in combination with furosemide in the treatment of moderate ascites in nonazotemic cirrhosis. A randomized comparative study of efficacy and safety. J Hepatol. 2003;39:187–92. [DOI] [PubMed]

38.

Sersté T, Melot C, Francoz C, Durand F, Rautou PE, Valla D, et al. Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites. Hepatology. 2010;52:1017–22. [DOI] [PubMed]

39.

Xu X, Gao F, Wang T, Yang Z, Zhao Q, Qi X. Association of non-selective β blockers with the development of renal dysfunction in liver cirrhosis: a systematic review and meta-analysis. Ann Med. 2024;56:2305935. [DOI] [PubMed] [PMC]

40.

Wong RJ, Robinson A, Ginzberg D, Gomes C, Liu B, Bhuket T. Assessing the safety of beta-blocker therapy in cirrhosis patients with ascites: A meta-analysis. Liver Int. 2019;39:1080–8. [DOI] [PubMed]

41.

Albillos A, García-Pagán JC, Iborra J, Bandi JC, Cacho G, Pérez-Paramo M, et al. Propranolol plus prazosin compared with propranolol plus isosorbide-5-mononitrate in the treatment of portal hypertension. Gastroenterology. 1998;115:116–23. [DOI] [PubMed]

42.

Villanueva C, Albillos A, Genescà J, Garcia-Pagan JC, Calleja JL, Aracil C, et al. β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019;393:1597–608. [DOI] [PubMed]

43.

Abd ElRahim AY, Fouad R, Khairy M, Elsharkawy A, Fathalah W, Khatamish H, et al. Efficacy of carvedilol versus propranolol versus variceal band ligation for primary prevention of variceal bleeding. Hepatol Int. 2018;12:75–82. [DOI] [PubMed]

44.

Groszmann RJ, Garcia-Tsao G, Bosch J, Grace ND, Burroughs AK, Planas R, et al.; Portal Hypertension Collaborative Group. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med. 2005;353:2254–61. [DOI] [PubMed]

45.

de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C; Baveno VII Faculty. Baveno VII – Renewing consensus in portal hypertension. J Hepatol. 2022;76:959–74. [DOI] [PubMed] [PMC]

46.

Villanueva C, Torres F, Sarin SK, Shah HA, Tripathi D, Brujats A, et al. Carvedilol reduces the risk of decompensation and mortality in patients with compensated cirrhosis in a competing-risk meta-analysis. J Hepatol. 2022;77:1014–25. [DOI] [PubMed]

47.

Kalambokis GN, Tsiakas I, Filippas-Ntekuan S, Christaki M, Despotis G, Milionis H. Empagliflozin Eliminates Refractory Ascites and Hepatic Hydrothorax in a Patient With Primary Biliary Cirrhosis. Am J Gastroenterol. 2021;116:618–9. [DOI] [PubMed]

48.

Miyamoto Y, Honda A, Yokose S, Nagata M, Miyamoto J. Weaning from concentrated ascites reinfusion therapy for refractory ascites by SGLT2 inhibitor. Clin Kidney J. 2021;15:831–3. [DOI] [PubMed] [PMC]

49.

Montalvo-Gordon I, Chi-Cervera LA, García-Tsao G. Sodium-Glucose Cotransporter 2 Inhibitors Ameliorate Ascites and Peripheral Edema in Patients With Cirrhosis and Diabetes. Hepatology. 2020;72:1880–2. [DOI] [PubMed]

50.

Bosch J, Gracia-Sancho J, Abraldes JG. Cirrhosis as new indication for statins. Gut. 2020;69:953–62. [DOI] [PubMed]

51.

Tapper EB, Zhao Z, Mazumder N, Parikh ND. Incidence of, Risk Factors for, and Outcomes After Ascites in a Population-Based Cohort of Older Americans. Dig Dis Sci. 2022;67:5327–35. [DOI] [PubMed] [PMC]

52.

Baldassarre M, Naldi M, Zaccherini G, Bartoletti M, Antognoli A, Laggetta M, et al. Determination of Effective Albumin in Patients With Decompensated Cirrhosis: Clinical and Prognostic Implications. Hepatology. 2021;74:2058–73. [DOI] [PubMed] [PMC]

53.

El Balkhi S, Rahali MA, Lakis R, Sauvage FL, Martin M, Janaszkiewicz A, et al. Early detection of liver injuries by the Serum enhanced binding test sensitive to albumin post-transcriptional modifications. Sci Rep. 2024;14:1434. [DOI] [PubMed] [PMC]

54.

Caraceni P, Riggio O, Angeli P, Alessandria C, Neri S, Foschi FG, et al.; ANSWER Study Investigators. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial. Lancet. 2018;391:2417–29. [DOI] [PubMed]

55.

Solà E, Solé C, Simón-Talero M, Martín-Llahí M, Castellote J, Garcia-Martínez R, et al. Midodrine and albumin for prevention of complications in patients with cirrhosis awaiting liver transplantation. A randomized placebo-controlled trial. J Hepatol. 2018;69:1250–9. [DOI] [PubMed]

56.

Di Pascoli M, Fasolato S, Piano S, Bolognesi M, Angeli P. Long-term administration of human albumin improves survival in patients with cirrhosis and refractory ascites. Liver Int. 2019;39:98–105. [DOI] [PubMed]

57.

China L, Freemantle N, Forrest E, Kallis Y, Ryder SD, Wright G, et al.; ATTIRE Trial Investigators. A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis. N Engl J Med. 2021;384:808–17. [DOI] [PubMed]

58.

Rössle M. TIPS: 25 years later. J Hepatol. 2013;59:1081–93. [DOI] [PubMed]

59.

Sanyal AJ, Genning C, Reddy KR, Wong F, Kowdley KV, Benner K, et al.; North American Study for the Treatment of Refractory Ascites Group. The North American Study for the Treatment of Refractory Ascites. Gastroenterology. 2003;124:634–41. [DOI] [PubMed]

60.

Trebicka J, Bastgen D, Byrtus J, Praktiknjo M, Terstiegen S, Meyer C, et al. Smaller-Diameter Covered Transjugular Intrahepatic Portosystemic Shunt Stents Are Associated With Increased Survival. Clin Gastroenterol Hepatol. 2019;17:2793–9.e1. [DOI] [PubMed]

61.

Perarnau JM, Le Gouge A, Nicolas C, d’Alteroche L, Borentain P, Saliba F, et al.; STIC-TIPS group. Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial. J Hepatol. 2014;60:962–8. [DOI] [PubMed]

62.

Narahara Y, Kanazawa H, Fukuda T, Matsushita Y, Harimoto H, Kidokoro H, et al. Transjugular intrahepatic portosystemic shunt versus paracentesis plus albumin in patients with refractory ascites who have good hepatic and renal function: a prospective randomized trial. J Gastroenterol. 2011;46:78–85. [DOI] [PubMed]

63.

Lebrec D, Giuily N, Hadengue A, Vilgrain V, Moreau R, Poynard T, et al.; Serge Erlinger French Group of Clinicians. Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. J Hepatol. 1996;25:135–44. [DOI] [PubMed]

64.

Rössle M, Ochs A, Gülberg V, Siegerstetter V, Holl J, Deibert P, et al. A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites. N Engl J Med. 2000;342:1701–7. [DOI] [PubMed]

65.

Ginès P, Uriz J, Calahorra B, Garcia-Tsao G, Kamath PS, Del Arbol LR, et al. Transjugular intrahepatic portosystemic shunting versus paracentesis plus albumin for refractory ascites in cirrhosis. Gastroenterology. 2002;123:1839–47. [DOI] [PubMed]

66.

Salerno F, Merli M, Riggio O, Cazzaniga M, Valeriano V, Pozzi M, et al. Randomized controlled study of TIPS versus paracentesis plus albumin in cirrhosis with severe ascites. Hepatology. 2004;40:629–35. [DOI] [PubMed]

67.

Benmassaoud A, Freeman SC, Roccarina D, Torres MC, Sutton AJ, Cooper NJ, et al. Treatment for ascites in adults with decompensated liver cirrhosis: a network meta-analysis. Cochrane Database Syst Rev. 2020;1:CD013123. [DOI] [PubMed] [PMC]

68.

Deltenre P, Mathurin P, Dharancy S, Moreau R, Bulois P, Henrion J, et al. Transjugular intrahepatic portosystemic shunt in refractory ascites: a meta-analysis. Liver Int. 2005;25:349–56. [DOI] [PubMed]

69.

D’Amico G, Luca A, Morabito A, Miraglia R, D’Amico M. Uncovered transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis. Gastroenterology. 2005;129:1282–93. [DOI] [PubMed]

70.

Albillos A, Bañares R, González M, Catalina M, Molinero LM. A meta-analysis of transjugular intrahepatic portosystemic shunt versus paracentesis for refractory ascites. J Hepatol. 2005;43:990–6. [DOI] [PubMed]

71.

Saab S, Nieto JM, Lewis SK, Runyon BA. TIPS versus paracentesis for cirrhotic patients with refractory ascites. Cochrane Database Syst Rev. 2006;2006:CD004889. [DOI] [PubMed] [PMC]

72.

Salerno F, Cammà C, Enea M, Rössle M, Wong F. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology. 2007;133:825–34. [DOI] [PubMed]

73.

Chen RP, Zhu Ge XJ, Huang ZM, Ye XH, Hu CY, Lu GR, et al. Prophylactic use of transjugular intrahepatic portosystemic shunt aids in the treatment of refractory ascites: metaregression and trial sequential meta-analysis. J Clin Gastroenterol. 2014;48:290–9. [DOI] [PubMed]

74.

Bai M, Qi XS, Yang ZP, Yang M, Fan DM, Han GH. TIPS improves liver transplantation-free survival in cirrhotic patients with refractory ascites: an updated meta-analysis. World J Gastroenterol. 2014;20:2704–14. [DOI] [PubMed] [PMC]

75.

Lv Y, Chen H, Luo B, Bai W, Li K, Wang Z, et al. Concurrent large spontaneous portosystemic shunt embolization for the prevention of overt hepatic encephalopathy after TIPS: A randomized controlled trial. Hepatology. 2022;76:676–88. [DOI] [PubMed]

76.

Ahmed Z, Farooq U, Faiza Arif S, Aziz M, Iqbal U, Nawaz A, et al. Transjugular Intrahepatic Portosystemic Shunt Outcomes in the Elderly Population: A Systematic Review and Meta-Analysis. Gastroenterology Res. 2022;15:325–33. [DOI] [PubMed] [PMC]

77.

Vizzutti F, Celsa C, Calvaruso V, Enea M, Battaglia S, Turco L, et al. Mortality after transjugular intrahepatic portosystemic shunt in older adult patients with cirrhosis: A validated prediction model. Hepatology. 2023;77:476–88. [DOI] [PubMed]

78.

Horhat A, Bureau C, Thabut D, Rudler M. Transjugular intrahepatic portosystemic shunt in patients with cirrhosis: Indications and posttransjugular intrahepatic portosystemic shunt complications in 2020. United European Gastroenterol J. 2021;9:203–8. [DOI] [PubMed] [PMC]

79.

Bureau C, Larrue H, Ganne Carrié N, Bourlière M; Groupe de travail. Recommandations TIPS: Indications et Modalités. Association Française pour l’Étude du Foie; 2023.

80.

Vilstrup H, Amodio P, Bajaj J, Cordoba J, Ferenci P, Mullen KD, et al. Hepatic encephalopathy in chronic liver disease: 2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60:715–35. [DOI] [PubMed]

81.

Schepis F, Vizzutti F, Garcia-Tsao G, Marzocchi G, Rega L, Maria ND, et al. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis. Clin Gastroenterol Hepatol. 2018;16:1153–62.e7. [DOI] [PubMed]

82.

Bureau C, Adebayo D, Chalret de Rieu M, Elkrief L, Valla D, Peck-Radosavljevic M, et al. Alfapump® system vs. large volume paracentesis for refractory ascites: A multicenter randomized controlled study. J Hepatol. 2017;67:940–9. [DOI] [PubMed]

83.

Nardelli S, Riggio O, Marra F, Gioia S, Saltini D, Bellafante D, et al. Episodic overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt does not increase mortality in patients with cirrhosis. J Hepatol. 2024;80:596–602. [DOI] [PubMed]

84.

Nardelli S, Lattanzi B, Torrisi S, Greco F, Farcomeni A, Gioia S, et al. Sarcopenia Is Risk Factor for Development of Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement. Clin Gastroenterol Hepatol. 2017;15:934–6. [DOI] [PubMed]

85.

Bureau C, Métivier S, D’Amico M, Péron JM, Otal P, Pagan JC, et al. Serum bilirubin and platelet count: a simple predictive model for survival in patients with refractory ascites treated by TIPS. J Hepatol. 2011;54:901–7. [DOI] [PubMed]

86.

Jansen C, Schröder A, Schueler R, Lehmann J, Praktiknjo M, Uschner FE, et al. Left Ventricular Longitudinal Contractility Predicts Acute-on-Chronic Liver Failure Development and Mortality After Transjugular Intrahepatic Portosystemic Shunt. Hepatol Commun. 2019;3:340–7. [DOI] [PubMed] [PMC]

87.

Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17:1321–60. [DOI] [PubMed]

88.

Billey C, Billet S, Robic MA, Cognet T, Guillaume M, Vinel JP, et al. A Prospective Study Identifying Predictive Factors of Cardiac Decompensation After Transjugular Intrahepatic Portosystemic Shunt: The Toulouse Algorithm. Hepatology. 2019;70:1928–41. [DOI] [PubMed]

89.

Lv Y, Qi X, He C, Wang Z, Yin Z, Niu J, et al.; PVT-TIPS Study Group. Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial. Gut. 2018;67:2156–68. [DOI] [PubMed]

90.

Mizrahi M, Adar T, Shouval D, Bloom AI, Shibolet O. Endotipsitis-persistent infection of transjugular intrahepatic portosystemic shunt: pathogenesis, clinical features and management. Liver Int. 2010;30:175–83. [DOI] [PubMed]

91.

Stepanova M, Nader F, Bureau C, Adebayo D, Elkrief L, Valla D, et al. Patients with refractory ascites treated with alfapump® system have better health-related quality of life as compared to those treated with large volume paracentesis: the results of a multicenter randomized controlled study. Qual Life Res. 2018;27:1513–20. [DOI] [PubMed]

92.

Weil-Verhoeven D, Di Martino V, Stirnimann G, Cervoni JP, Nguyen-Khac E, Thévenot T. Alfapump^® implantable device in management of refractory ascites: An update. World J Hepatol. 2022;14:1344–56. [DOI] [PubMed] [PMC]

93.

Aagaard NK, Malago M, De Gottardi A, Thomas M, Sauter G, Engelmann C, et al. Consensus care recommendations for alfapump® in cirrhotic patients with refractory or recurrent ascites. BMC Gastroenterol. 2022;22:111. [DOI] [PubMed] [PMC]

94.

Lepida A, Marot A, Trépo E, Degré D, Moreno C, Deltenre P. Systematic review with meta-analysis: automated low-flow ascites pump therapy for refractory ascites. Aliment Pharmacol Ther. 2019;50:978–87. [DOI] [PubMed]

95.

Stirnimann G, Berg T, Spahr L, Zeuzem S, McPherson S, Lammert F, et al. Final safety and efficacy results from a 106 real-world patients registry with an ascites-mobilizing pump. Liver Int. 2022;42:2247–59. [DOI] [PubMed] [PMC]

96.

Wong F, Bendel E, Sniderman K, Frederick T, Haskal ZJ, Sanyal A, et al. Improvement in Quality of Life and Decrease in Large-Volume Paracentesis Requirements With the Automated Low-Flow Ascites Pump. Liver Transpl. 2020;26:651–61. [DOI] [PubMed] [PMC]

97.

Thomas MN, Sauter GH, Gerbes AL, Stangl M, Schiergens TS, Angele M, et al. Automated low flow pump system for the treatment of refractory ascites: a single-center experience. Langenbecks Arch Surg. 2015;400:979–83. [DOI] [PubMed]

98.

Heuman DM, Abou-Assi SG, Habib A, Williams LM, Stravitz RT, Sanyal AJ, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology. 2004;40:802–10. [DOI] [PubMed]

99.

Carrier P, Destere A, Giguet B, Debette-Gratien M, Essig M, Monchaud C, et al. Iohexol plasma and urinary concentrations in cirrhotic patients: A pilot study. World J Hepatol. 2022;14:1621–32. [DOI] [PubMed] [PMC]

100.

Francoz C, Nadim MK, Baron A, Prié D, Antoine C, Belghiti J, et al. Glomerular filtration rate equations for liver-kidney transplantation in patients with cirrhosis: validation of current recommendations. Hepatology. 2014;59:1514–21. [DOI] [PubMed]

101.

Carrier P, Debette-Gratien M, Essig M, Loustaud-Ratti V. Beyond serum creatinine: which tools to evaluate renal function in cirrhotic patients? Hepatol Res. 2018;48:771–9. [DOI] [PubMed]

102.

Guarner C, Runyon BA. Ascites. In: McNally PR, editor. GI/Liver Secrets. 4th ed. Philadelphia: Elsevier Inc.; 2010. pp. 217–27. [DOI]

103.

Sort P, Navasa M, Arroyo V, Aldeguer X, Planas R, Ruiz-del-Arbol L, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999;341:403–9. [DOI] [PubMed]

104.

de Araujo A, de Barros Lopes A, Rossi G, da Silva GV, Ananias P, Ness S, et al. Low-dose albumin in the treatment of spontaneous bacterial peritonitis: should we change the standard treatment? Gut. 2012;61:1371–2. [DOI] [PubMed]

105.

Sigal SH, Stanca CM, Fernandez J, Arroyo V, Navasa M. Restricted use of albumin for spontaneous bacterial peritonitis. Gut. 2007;56:597–9. [DOI] [PubMed] [PMC]

106.

Kim JJ, Tsukamoto MM, Mathur AK, Ghomri YM, Hou LA, Sheibani S, et al. Delayed paracentesis is associated with increased in-hospital mortality in patients with spontaneous bacterial peritonitis. Am J Gastroenterol. 2014;109:1436–42. [DOI] [PubMed]

107.

Runyon BA. Monomicrobial nonneutrocytic bacterascites: a variant of spontaneous bacterial peritonitis. Hepatology. 1990;12:710–5. [DOI] [PubMed]

108.

McNamara PJ, Gibaldi M, Stoeckel K. Volume of distribution terms for a drug (ceftriaxone) exhibiting concentration-dependent protein binding. II. Physiological significance. Eur J Clin Pharmacol. 1983;25:407–12. [DOI] [PubMed]

109.

Mazer L, Tapper EB, Piatkowski G, Lai M. The need for antibiotic stewardship and treatment standardization in the care of cirrhotic patients with spontaneous bacterial peritonitis - a retrospective cohort study examining the effect of ceftriaxone dosing. F1000Res. 2014;3:57. [DOI] [PubMed] [PMC]

110.

Fiore M, Maraolo AE, Gentile I, Borgia G, Leone S, Sansone P, et al. Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis. World J Hepatol. 2017;9:1166–1175. [DOI] [PubMed] [PMC]

111.

Piroth L, Pechinot A, Di Martino V, Hansmann Y, Putot A, Patry I, et al. Evolving epidemiology and antimicrobial resistance in spontaneous bacterial peritonitis: a two-year observational study. BMC Infect Dis. 2014;14:287. [DOI] [PubMed] [PMC]

112.

Marciano S, Díaz JM, Dirchwolf M, Gadano A. Spontaneous bacterial peritonitis in patients with cirrhosis: incidence, outcomes, and treatment strategies. Hepat Med. 2019;11:13–22. [DOI] [PubMed] [PMC]

113.

Fernández J, Navasa M, Planas R, Montoliu S, Monfort D, Soriano G, et al. Primary prophylaxis of spontaneous bacterial peritonitis delays hepatorenal syndrome and improves survival in cirrhosis. Gastroenterology. 2007;133:818–24. [DOI] [PubMed]

114.

Banini BA, Alwatari Y, Stovall M, Ogden N, Gershman E, Shah RD, et al. Multidisciplinary Management of Hepatic Hydrothorax in 2020: An Evidence-Based Review and Guidance. Hepatology. 2020;72:1851–63. [DOI] [PubMed]

115.

Cadranel JD, Ollivier-Hourmand I, Cadranel J, Thevenot T, Zougmore H, Nguyen-Khac E, et al. International survey among hepatologists and pulmonologists on the hepatic hydrothorax: plea for recommendations. BMC Gastroenterol. 2023;23:305. [DOI] [PubMed] [PMC]

116.

Sigal SH, Amin A, Chiodo JA 3rd, Sanyal A. Management Strategies and Outcomes for Hyponatremia in Cirrhosis in the Hyponatremia Registry. Can J Gastroenterol Hepatol. 2018;2018:1579508. [DOI] [PubMed] [PMC]

117.

Bajaj JS, Tandon P, OʼLeary JG, Biggins SW, Wong F, Kamath PS, et al. The Impact of Albumin Use on Resolution of Hyponatremia in Hospitalized Patients With Cirrhosis. Am J Gastroenterol. 2018;113:1339. [DOI] [PubMed]

118.

Chai L, Li Z, Wang T, Wang R, Pinyopornpanish K, Cheng G, et al. Efficacy and safety of tolvaptan in cirrhotic patients: a systematic review and meta-analysis of randomized controlled trials. Expert Rev Gastroenterol Hepatol. 2023;17:1041–51. [DOI] [PubMed]

119.

Pose E, Solà E, Piano S, Gola E, Graupera I, Guevara M, et al. Limited Efficacy of Tolvaptan in Patients with Cirrhosis and Severe Hyponatremia: Real-Life Experience. Am J Med. 2017;130:372–5. [DOI] [PubMed]

120.

Cárdenas A, Ginès P, Marotta P, Czerwiec F, Oyuang J, Guevara M, et al. Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis. J Hepatol. 2012;56:571–8. [DOI] [PubMed]

121.

Yun BC, Kim WR, Benson JT, Biggins SW, Therneau TM, Kremers WK, et al. Impact of pretransplant hyponatremia on outcome following liver transplantation. Hepatology. 2009;49:1610–5. [DOI] [PubMed] [PMC]

122.

Crivellin C, Cagnin A, Manara R, Boccagni P, Cillo U, Feltracco P, et al. Risk factors for central pontine and extrapontine myelinolysis after liver transplantation: a single-center study. Transplantation. 2015;99:1257–64. [DOI] [PubMed]

123.

Durand F, Buyse S, Francoz C, Laouénan C, Bruno O, Belghiti J, et al. Prognostic value of muscle atrophy in cirrhosis using psoas muscle thickness on computed tomography. J Hepatol. 2014;60:1151–7. [DOI] [PubMed]

124.

Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al.; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48:601. [DOI] [PubMed] [PMC]

125.

Bunchorntavakul C, Reddy KR. Review article: malnutrition/sarcopenia and frailty in patients with cirrhosis. Aliment Pharmacol Ther. 2020;51:64–77. [DOI] [PubMed]

126.

Topan MM, Sporea I, Dănilă M, Popescu A, Ghiuchici AM, Lupuşoru R, et al. Impact of Sarcopenia on Survival and Clinical Outcomes in Patients With Liver Cirrhosis. Front Nutr. 2021;8:766451. [DOI] [PubMed] [PMC]

127.

Kim G, Kang SH, Kim MY, Baik SK. Prognostic value of sarcopenia in patients with liver cirrhosis: A systematic review and meta-analysis. PLoS One. 2017;12:e0186990. [DOI] [PubMed] [PMC]

128.

Montano-Loza AJ, Duarte-Rojo A, Meza-Junco J, Baracos VE, Sawyer MB, Pang JX, et al. Inclusion of Sarcopenia Within MELD (MELD-Sarcopenia) and the Prediction of Mortality in Patients With Cirrhosis. Clin Transl Gastroenterol. 2015;6:e102. [DOI] [PubMed] [PMC]

129.

Huelin P, Solà E, Elia C, Solé C, Risso A, Moreira R, et al. Neutrophil Gelatinase-Associated Lipocalin for Assessment of Acute Kidney Injury in Cirrhosis: A Prospective Study. Hepatology. 2019;70:319–33. [DOI] [PubMed]

130.

Maurel P, Prémaud A, Carrier P, Essig M, Barbier L, Rousseau A, et al. Evaluation of Longitudinal Exposure to Tacrolimus as a Risk Factor of Chronic Kidney Disease Occurrence Within the First-year Post-Liver Transplantation. Transplantation. 2021;105:1585–94. [DOI] [PubMed]

131.

Ojo AO, Held PJ, Port FK, Wolfe RA, Leichtman AB, Young EW, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349:931–40. [DOI] [PubMed]

132.

Ginès P, Solà E, Angeli P, Wong F, Nadim MK, Kamath PS. Hepatorenal syndrome. Nat Rev Dis Primers. 2018;4:23. [DOI] [PubMed]

133.

Angeli P, Ginès P, Wong F, Bernardi M, Boyer TD, Gerbes A, et al. Diagnosis and management of acute kidney injury in patients with cirrhosis: revised consensus recommendations of the International Club of Ascites. J Hepatol. 2015;62:968–74. [DOI] [PubMed]

134.

Mazumder NR, Junna S, Sharma P. The Diagnosis and Non-pharmacological Management of Acute Kidney Injury in Patients with Cirrhosis. Clin Gastroenterol Hepatol. 2023;21:S11–9. [DOI] [PubMed]

135.

Arora V, Choudhary SP, Maiwall R, Vijayaraghavan R, Jindal A, Kumar G, et al. Low-dose continuous terlipressin infusion is effective and safer than intravenous bolus injections in reducing portal pressure and control of acute variceal bleeding. Hepatol Int. 2023;17:131–8. [DOI] [PubMed]

136.

Garcia-Tsao G, Abraldes JG, Rich NE, Wong VW. AGA Clinical Practice Update on the Use of Vasoactive Drugs and Intravenous Albumin in Cirrhosis: Expert Review. Gastroenterology. 2024;166:202–10. [DOI] [PubMed]

137.

Wong F, Pappas SC, Curry MP, Reddy KR, Rubin RA, Porayko MK, et al.; CONFIRM Study Investigators. Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome. N Engl J Med. 2021;384:818–28. [DOI] [PubMed]

138.

Cavallin M, Piano S, Romano A, Fasolato S, Frigo AC, Benetti G, et al. Terlipressin given by continuous intravenous infusion versus intravenous boluses in the treatment of hepatorenal syndrome: A randomized controlled study. Hepatology. 2016;63:983–92. [DOI] [PubMed]

139.

Flamm SL, Wong F, Ahn J, Kamath PS. AGA Clinical Practice Update on the Evaluation and Management of Acute Kidney Injury in Patients With Cirrhosis: Expert Review. Clin Gastroenterol Hepatol. 2022;20:2707–16. [DOI] [PubMed]

140.

Kwong A, Kim WR, Kwo PY, Wang U, Cheng X. Feasibility and Effectiveness of Norepinephrine Outside the Intensive Care Setting for Treatment of Hepatorenal Syndrome. Liver Transpl. 2021;27:1095–105. [DOI] [PubMed] [PMC]

141.

Angeli P, Rodríguez E, Piano S, Ariza X, Morando F, Solà E, et al.; CANONIC Study Investigators of EASL-CLIF Consortium. Acute kidney injury and acute-on-chronic liver failure classifications in prognosis assessment of patients with acute decompensation of cirrhosis. Gut. 2015;64:1616–22. [DOI] [PubMed]

142.

Nadim MK, Sung RS, Davis CL, Andreoni KA, Biggins SW, Danovitch GM, et al. Simultaneous liver-kidney transplantation summit: current state and future directions. Am J Transplant. 2012;12:2901–8. [DOI] [PubMed]

143.

Nadim MK, Kellum JA, Davenport A, Wong F, Davis C, Pannu N, et al. Hepatorenal syndrome: the 8th International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2012;16:R23. [DOI] [PubMed] [PMC]

144.

Gonzalez-Garay AG, Serralde-Zúñiga AE, Velasco Hidalgo L, Flores García NC, Aguirre-Salgado MI. Transjugular intrahepatic portosystemic shunts for adults with hepatorenal syndrome. Cochrane Database Syst Rev. 2024;1:CD011039. [DOI] [PubMed]