2025 Webinar: Portosinusoidal Vascular Disorders - A New Paradigm in Noncirrhotic Portal Hypertension (enduring)-PSVD Webinar Replay

Video Transcription

Video Summary

In this webinar, hosted by Professor Patrick Northup from NYU Langone Transplant Institute, experts discussed the challenges and advancements related to portosinusoidal vascular disorders (PSVD). This disorder is often associated with portal hypertension but can present without it, which raises questions about its pathophysiology and management. Dr. Andrea De Gottardi highlighted potential pathways to this condition, emphasizing the importance of liver biopsy for diagnosis and explaining that PSVD encompasses conditions like obliterative portal venopathy and nodular regenerative hyperplasia. He noted that elevated gamma GT levels and specific imaging and laboratory findings could suggest PSVD, though the condition lacks specific causal treatments due to insufficient understanding of its mechanisms.<br /><br />Dr. Patrick Kamath clarified the synonymous use of idiopathic portal hypertension and PSVD, expressing a preference for the clinical term, IPH. He mentioned that the condition's prognosis varies greatly depending on any associated systemic diseases, which also drive the management approach—primarily focusing on managing complications of portal hypertension, such as bleeding. Beta-blockers, shunts, and TIPS are used similar to their application in cirrhosis-related hypertension. Liver transplantation is rarely needed unless complications advance significantly, and while the disease can develop post-transplant, it doesn't typically recur. The need for a better classification and understanding of PSVD was emphasized, as current terminologies do not sufficiently cover its clinical implications.

Keywords

portosinusoidal vascular disorders

PSVD

portal hypertension

liver biopsy

obliterative portal venopathy

nodular regenerative hyperplasia

idiopathic portal hypertension

gamma GT levels

TIPS

liver transplantation