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Use of Non-selective Beta blockers in Decompensated Cirrhosis and ACLF

Gananandan, Kohilan; Mookerjee, Raj; Jalan, Rajiv; (2022) Use of Non-selective Beta blockers in Decompensated Cirrhosis and ACLF. Current Hepatology Reports , 21 (3) pp. 29-36. 10.1007/s11901-022-00584-2. Green open access

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Abstract

Purpose of Review: Our understanding of beta blockers in liver cirrhosis has transformed over the last 40 years. However, questions remain over their safety in acute decompensation and acute on chronic liver failure. Since these conditions are associated with significant morbidity and mortality, a critical appraisal of recent literature is imperative to help guide clinicians. Recent Findings: The latest BAVENO guidelines now recommend carvedilol in all patients with clinically significant portal hypertension to prevent decompensation. There is significant data which shows safety of beta blocker use in decompensated cirrhosis but concerns remain in refractory ascites. There is also a short-term mortality benefit demonstrated in acute on chronic liver failure. Summary: With the latest guidelines and recent evidence, it seems beta blocker use will continue to increase. Future studies should aim to identify biomarkers that can determine who will benefit from beta blockers and help guide therapy.

Type: Article
Title: Use of Non-selective Beta blockers in Decompensated Cirrhosis and ACLF
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s11901-022-00584-2
Publisher version: https://doi.org/10.1007/s11901-022-00584-2
Language: English
Additional information: Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords: Beta blockers · Decompensated cirrhosis · ACLF
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10162509
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