National Endoscopic ultrasound portal pressure gradient registry

During an endoscopic ultrasound procedure the portal pressure gradient is measured. Elevation of the portal pressure gradient assists in diagnosis and prognosis of cirrhosis. Hepatic venous pressure gradient (HVPG) is the gold standard for evaluating the presence and severity of portal hypertension (PHTN). HVPG >10 mmHg defines clinically significant Portal hypertension, as this critical threshold predicts for increased risk of decompensation events, including decompensation following liver resection, and death.Endoscopic ultrasound-portal pressure gradient (EUS-PPG) is a novel TGA-approved alternative to HVPG that has been shown in pilot studies to be safe and technically successful for the evaluation and determination of PHTN. EUS-PPG can be performed simultaneously with routine variceal surveillance and can be repeated to provide longitudinal HVPG measurements. Data regarding use in clinical practice is limited. This prospective registry seeks to evaluate the clinical utility of EUS-PPG assessment across multiple tertiary centres. This is a multi-centre prospective registry designed to collect data relating to clinical EUS-PPG assessment, such that the role for EUS-PPG in PHTN investigation, identification, stratification and management may be better understood. The EUS-PPG procedure takes approximately 30 minutes and will be performed once only. Participants will have routine blood tests prior to enrolling to determine eligibility and baseline comorbid status. There is no future specimens to be collected. Baseline demographical, clinical health data and baseline liver status (Bloods, Child Pugh score, abdominal ultrasound findings, fibroscan, medical examination) is collected at baseline. Procedural data is collected (presence of varices, location, high risk stigmata for bleeding, portal hypertensive gastropathy presence), EUS assessment of Portal and Hepatic veins, measurements of the portal vein and hepatic veins, points of access, technical success, calculation of the PPG, length of procedure time, medications administered, additional procedures required, post procedural recommendations. Complications immediate, immediate post-procedure, adverse events via phone calls at Day 7 and Day 30 There are no questionnaires to be collected by the participant for this registry. Longitudinal clinical data will be collected for up to 5 years on each participant