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Early identification of hepatic decompensation is important in appropriately timing liver transplantation referral, and a major component of prognosis is development of portal hypertension. Currently, the best tool to determine portal hypertension is measurement of the hepatic venous pressure gradient, which requires technical skills and is invasive.
To evaluate the performance of an alternative measure — spleen stiffness — in predicting hepatic decompensation and mortality in this setting, investigators in Japan prospectively evaluated 393 patients using acoustic radiation force impulse imaging to evaluate spleen stiffness, laboratory testing, and endoscopy every 3–6 months until death, liver transplantation, or study end.
During a median fo…