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World J Hepatol. Mar 27, 2015; 7(3): 607-615
Published online Mar 27, 2015. doi: 10.4254/wjh.v7.i3.607
Staging of liver fibrosis or cirrhosis: The role of hepatic venous pressure gradient measurement
Ki Tae Suk, Dong Joon Kim
Ki Tae Suk, Dong Joon Kim, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea
Author contributions: Suk KT and Kim DJ equally contributed to the highlight topic: “Staging of liver fibrosis or cirrhosis - the role of HVPG measurement”.
Supported by A grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, No. NRF-2010-0021482; Cooperative Research Program for Agriculture Science and Technology Development Rural Development Administration, South Korea, No. PJ009859.
Conflict-of-interest: Authors attest that there are no commercial associations that might be a conflict of interest in relation to the submitted manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dong Joon Kim, MD, PhD, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon 200-704, South Korea. djkim@hallym.ac.kr
Telephone: +82-33-2405647 Fax: +82-33-2418064
Received: August 27, 2014
Peer-review started: August 28, 2014
First decision: November 3, 2014
Revised: December 11, 2014
Accepted: December 29, 2014
Article in press: December 29, 2014
Published online: March 27, 2015
Abstract

Liver fibrosis is a common histological change of chronic liver injury and it is closely related with portal hypertension which is hemodynamic complication of chronic liver disease. Currently, liver fibrosis has been known as a reversible dynamic process in previous literatures. Although liver biopsy is a gold standard for assessing the stage of liver fibrosis, it may not completely represent the stage of liver fibrosis because of sampling error or semi-quantative measurement. Recent evidences suggested that histologic, clinical, hemodynamic, and biologic features are closely associated in patients with chronic liver disease. Hepatic venous pressure gradient (HVPG) measurement has been known as a modality to evaluate the portal pressure. The HVPG measurement has been used clinically for fibrosis diagnosis, risk stratification, preoperative screening for liver resection, monitoring the efficacy of medical treatments, and assessing the prognosis of liver fibrosis. Therefore, the HVPG measurement can be used to monitor areas the chronic liver disease but also other important areas of chronic liver disease.

Keywords: Fibrosis, Liver, Venous pressure

Core tip: Hepatic venous pressure gradient (HVPG) measurement has been used in the clinical fields such as diagnosis of fibrosis, risk stratification, preoperative screening for liver resection, monitoring of the efficacy of medical treatment, and assessing the prognosis of liver fibrosis. HVPG measurement, along with monitoring stage the liver fibrosis, will play important roles in the field of chronic liver disease.