Advances in portal hypertension management: Evolution of the Baveno guidelines

Table 1 Criteria for exclusion, suspicion, and diagnosis of compensated advanced chronic liver disease and indications for endoscopy based on non-invasive diagnostic tests according to Baveno VI and VII

	Baveno VI[20], 2015	Baveno VII[1], 2022
Exclusion of cACLD	TE1 < 10 kPa and absence of clinical symptoms of disease	TE1 < 10 kPa and absence of clinical and imaging signs of disease
Suspicion of cACLD	TE1 10-15 kPa	TE1 10-15 kPa
High suspicion of cACLD	TE1 > 15 kPa	TE1 > 15 kPa
Diagnosis of cACLD	Advanced fibrosis or cirrhosis in histopathological examination; Esophageal varices; HVPG > 5 mmHg	Definition of cACLD based on liver stiffness measurement
Exclusion of CSPH in cACLD	No recommendation	TE1 ≤ 15 kPa and PLT ≥ 150000/μL
Confirmation of CSPH in cACLD	HVPG ≥ 10 mmHg; TE1 ≤ 20-25 kPa alone or in combination with PLT and spleen size assessment (in the etiology of viral liver disease); Imaging studies showing collateral circulation	TE1 ≥ 25 kPa (applies to patients with cACLD related to virus and/or alcohol and/or NASH without obesity)
Indications for endoscopy	TE1 ≥ 20 kPa or PLT ≤ 150000/μL	TE1 ≥ 20 kPa or PLT ≤ 150000/μL
SSM	No recommendation	It can be used in chronic viral hepatitis to exclude CSPH (< 21 kPa) and diagnose CSPH (> 50 kPa); In individuals with SSM ≤ 40 kPa, endoscopy can be omitted

¹Liver fibrosis assessed using transient elastography.

cACLD: Compensated advanced chronic liver disease; CSPH: Clinically significant portal hypertension; HVPG: Hepatic venous pressure gradient; NASH: Non-alcoholic steatohepatitis; PLT: Platelet count; SSM: Spleen stiffness measurement; TE: Transient elastography.