Prediction of improved liver function after balloon-occluded retrograde transvenous obliteration: Relation to hepatic vein pressure gradient

Background and Aims: Balloon-occluded retrograde transvenous obliteration (B-RTO) is an effective treatment for gastric varices (GVx), as well as hepatic encephalopathy. The aim of this study was to examine the changes of the hepatic vein pressure gradient (HVPG) after B-RTO and determine the relation between the changes of HVPG and liver function. Patients and Methods: B-RTO was performed in 30 patients with GVx and hepatic encephalopathy. HVPG was measured in 19 of 30 patients both before and after B-RTO. Results: The B-RTO was successful in all patients. The GVx and hepatic encephalopathy were improved, and no recurrence or bleeding was observed within the follow- up period. The serum albumin and prothrombin activity were significantly improved 6months after B-RTO in all patients. HVPG was elevated 44% above the baseline after B-RTO. Liver function significantly improved 6months after B-RTO in patients whose HVPG increased≥20% from baseline. Conclusion: An elevated HVPG after B-RTO is one aspect of the effect of liver function, and an HVPG increase of≥20% from baseline is a predictive factor for obtaining an improvement of liver function.