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Measurement of Hepatic Venous Pressure Gradient Is Feasible and Safe in Children

Woolfson, Jessica*; John, Philip; Kamath, Binita; Ng, Vicky L.; Ling, Simon C.

Journal of Pediatric Gastroenterology and Nutrition: November 2013 - Volume 57 - Issue 5 - p 634–637
doi: 10.1097/MPG.0b013e3182a0e114
Original Articles: Hepatology and Nutrition

Background and Objectives: Hepatic venous pressure gradient (HVPG) is an indirect measure of portal venous pressure in cirrhosis, which is valid in cirrhotic adults for evaluating the severity of portal hypertension, predicting outcomes, and guiding therapeutic decisions. Published data on the measurement of HVPG in children are sparse. The aim of the present study was to determine the feasibility and safety of undertaking HVPG measurements in children.

Methods: Children who underwent HVPG measurements between 2000 and 2011 were identified from our interventional radiology database. Medical charts were reviewed for clinical, procedural, and outcome data.

Results: A total of 49 patients (25 boys, mean age 8.2 ± 5.6 years) underwent 52 HVPG measurements. Diagnoses included cirrhosis (n = 7), acute liver failure (n = 15), postliver transplant (n = 6), postbone marrow transplant (n = 9), vascular anomalies (n = 3), and others (n = 9). There were no complications related to HVPG measurement. HVPG values ranged between 0 and 28 mmHg, median 9.0 (range 0–28) mmHg, and were elevated >6 mmHg in 30 patients.

Conclusions: HVPG measurement is feasible and safe in children with severe liver disease. The clinical use of HVPG measurements in managing children with portal hypertension or with acute liver diseases must now be determined.

*Division of Gastroenterology, Hepatology, and Nutrition

Department of Paediatrics, University of Toronto

Division of Interventional Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Address correspondence and reprint requests to Simon C. Ling, MBChB, Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8, Canada (e-mail:

Received 15 January, 2013

Accepted 14 June, 2013

The authors report no conflicts of interest.

© 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,