‘Non-invasive assessment of portal hypertension and its response to portal-pressure-reducing pharmacological therapy’

Guadalupe García-Tsao, Juan Carlos García-Pagán, Juan González Abraldes.

The project comprises two separate but related studies. The first will examine the combination of two non-invasive techniques in the determination of portal pressure and its response to pharmacological therapy. Portal pressure will be measured by the standard method (HVPG) as well as indirectly by the measurement of liver stiffness (transient elastography) and portal/hepatic blood flow (echo-Doppler). The hypothesis is that the product of liver stiffness and inflow should correlate with HVPG.

The second study will use ACA (Adaptive Conjoint Analysis), a methodology developed in the visiting professor’s lab, consisting of an interactive computer program that collects and analyzes predicted patient preferences for different therapies in an unbiased objective manner. This technique has been validated in the United States, but its reproducibility in Spanish-speaking countries and its ability to improve outcomes has not been analyzed. The hypothesis is that ACA-directed therapy will be able to be translated to Spain and will improve some of the outcomes (treatment adherence, cost) in patients who are candidates for primary prophylaxis of variceal hemorrhage.