Prognostic and natural history of PSVD with signs of portal hypertension

Prognostic and natural history of PSVD with signs of portal hypertension

by Juan-Carlos Garcia-Pagan

Life & Natural Systems Medicine & Health MMedicine and NursingMJJHepatology
🎙 Juan-Carlos Garcia-Pagan 👥 2K 📅 January 23, 2026 ⏱ 30 min 👁 77 📄 expert opinion 🧭 2026-08-16
Available in: English (current) Français

Keywords

PSVDportal hypertensionprognosisnatural historyliver transplantation

Summary

This presentation by Prof. Juan-Carlos Garcia-Pagan at the Paris PSVD Meeting 2025 reviews the prognosis and natural history of Porto-Sinusoidal Vascular Disease (PSVD) with signs of portal hypertension. He begins by summarizing data from 12 cohorts, noting that patients are typically young (mean age ~40), predominantly male, and often asymptomatic despite portal hypertension. Survival is excellent at 1 year but declines to 52-87% at 5 years and 30-78% at 10 years. The Baldi study, a large European cohort of 587 patients, is highlighted: 64% asymptomatic, with ascites and variceal bleeding as common symptoms. Liver transplant-free survival was 83% at 5 years and 72% at 10 years. Independent prognostic factors include age, severity of associated conditions, creatinine, bilirubin, albumin, and ascites. A nomogram (PSVD score) was developed to predict survival. Hepatic venous pressure gradient (HVPG) has predictive value but does not improve the model. The impact of associated conditions (e.g., CVID, oxaliplatin, HIV) on survival is discussed. Sarcopenia is emerging as a prognostic factor in decompensated patients. Rates of decompensation, variceal bleeding, ascites, and portal vein thrombosis are detailed. The presentation concludes with a Q&A session addressing clinical management, including the use of beta-blockers, TIPS, and splenectomy.

196 words

Critical Evaluation

Value of the Information & Strength of the Argument

The presentation provides high-value data from a large multicenter cohort, offering robust estimates of survival and prognostic factors. The argumentation is solid, based on multivariate analyses and a nomogram validated internally. The speaker acknowledges limitations, such as retrospective design and heterogeneity of cohorts. The discussion of associated conditions and their impact on prognosis is particularly valuable. The Q&A adds practical insights, but some answers are based on expert opinion rather than strong evidence.

Scientific Rigor, Source Quality, Title Accuracy

The presentation is scientifically rigorous, referencing multiple cohorts and the large Baldi study. The speaker is a recognized expert, and the data align with published literature. The title accurately reflects the content. No external sources are cited in the video description, but the speaker mentions a submitted paper on sarcopenia. The Q&A reveals a preference for the PSVD score over MELD or Child-Pugh, which is supported by the data presented.

158 words

Title / Content Match

The title accurately reflects the content, which focuses on prognosis and natural history of PSVD with portal hypertension.

Quality & Reliability

8/10

Presentation by a leading expert in the field, based on a large multicenter cohort (Baldi study) and a review of 12 cohorts. Data are consistent with published literature, but some studies are not yet published (e.g., sarcopenia paper).

Key Moments

Markers derived by PSI from the transcript: the creator did not define chapters.

Cited Sources

  • Baldi study (unpublished data) — Large multicenter cohort of 587 PSVD patients from Europe and India, presented in this talk.
  • Sarcopenia in PSVD (submitted paper) — Study on prevalence and prognostic value of sarcopenia in PSVD, mentioned as submitted.

Concurring Sources

  • Natural history of porto-sinusoidal vascular disease: a systematic review — Published literature on PSVD natural history, consistent with presented data.

Contribution & Novelties

This presentation synthesizes current knowledge on PSVD prognosis, highlighting the Baldi study’s large cohort and the development of a PSVD-specific nomogram. It emphasizes the importance of associated conditions and introduces sarcopenia as a novel prognostic factor. The Q&A provides practical clinical guidance.

Pour aller plus loin :

77 words

Radar Profile

The radar profile shows high scores across all dimensions, indicating a technically detailed and reliable presentation with substantial information. The balance between quantity and quality is strong, and the expert opinion is well-supported by data.

Reliability 8/10