{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T01:11:50Z","timestamp":1794186710527,"version":"4.8.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:00:00Z","timestamp":1639180800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:00:00Z","timestamp":1639180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary biliary cholangitis (PBC) may progress to cirrhosis and clinically significant portal hypertension (CSPH). This study assesses different features of CSPH and their distinct prognostic impact regarding decompensation and survival in patients with PBC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with PBC were identified during a database query of our digital patient reporting system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 333 PBC patients (mean age 54.3\u00a0years, 86.8% females, median follow-up 5.8\u00a0years) were retrospectively assessed and 127 (38.1%) showed features of CSPH: 63 (18.9%) developed varices, 98 (29.4%) splenomegaly, 62 (18.6%) ascites and 20 (15.7%) experienced acute variceal bleeding. Splenomegaly, portosystemic collaterals and esophageal varices were associated with an increased 5-year (5Y) risk of decompensation (15.0%, 17.8% and 20.9%, respectively). Patients without advanced chronic liver disease (ACLD) had a similar 5Y-transplant free survival (TFS) (96.6%) compared to patients with compensated ACLD (cACLD) but without CSPH (96.9%). On the contrary, PBC patients with cACLD and CSPH (57.4%) or decompensated ACLD (dACLD) (36.4%) had significantly decreased 5Y survival rates. The combination of LSM\u2009&lt;\u200915\u00a0kPa and platelets\u2009\u2265\u2009150G\/L indicated a negligible risk for decompensation (5Y 0.0%) and for mortality (5Y 0.0%). Overall, 44 (13.2%) patients died, with 18 (40.9%) deaths attributed to CSPH-related complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In PBC, features of CSPH may occur early and indicate an increased risk for subsequent decompensation and mortality. Hence, regular screening and on-time treatment for CSPH is crucial. Combining LSM and platelets serves as a valuable preliminary assessment, as LSM\u2009&lt;\u200915\u00a0kPa and platelets\u2009\u2265\u2009150G\/L indicate an excellent long-term outcome.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00535-021-01839-3","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T04:27:22Z","timestamp":1639196842000},"page":"99-110","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Distinct prognostic value of different portal hypertension-associated features in patients with primary biliary cholangitis"],"prefix":"10.1007","volume":"57","author":[{"given":"Lukas","family":"Burghart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emina","family":"Halilbasic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Schwabl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Simbrunner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Friedrich","family":"St\u00e4ttermayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oleksandr","family":"Petrenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Pinter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaan","family":"Boztug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,11]]},"reference":[{"key":"1839_CR1","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1038\/ajg.2017.440","volume":"113","author":"MH Harms","year":"2018","unstructured":"Harms MH, Lammers WJ, Thorburn D, et al. Major hepatic complications in ursodeoxycholic acid-treated patients with primary biliary cholangitis: risk factors and time trends in incidence and outcome. Am J Gastroenterol. 2018;113:254\u201364.","journal-title":"Am J Gastroenterol"},{"key":"1839_CR2","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.jhep.2017.03.022","volume":"67","author":"European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver","year":"2017","unstructured":"European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL clinical practice guidelines: the diagnosis and management of patients with primary biliary cholangitis. J Hepatol. 2017;67:145\u201372.","journal-title":"J Hepatol"},{"key":"1839_CR3","doi-asserted-by":"publisher","first-page":"1804","DOI":"10.1053\/j.gastro.2015.07.061","volume":"149","author":"WJ Lammers","year":"2015","unstructured":"Lammers WJ, Hirschfield GM, Corpechot C, et al. Development and validation of a scoring system to predict outcomes of patients with primary biliary cirrhosis receiving ursodeoxycholic acid therapy. Gastroenterology. 2015;149:1804-1812.e4.","journal-title":"Gastroenterology"},{"key":"1839_CR4","doi-asserted-by":"publisher","first-page":"560","DOI":"10.1053\/j.gastro.2012.12.005","volume":"144","author":"M Carbone","year":"2013","unstructured":"Carbone M, Mells GF, Pells G, et al. Sex and age are determinants of the clinical phenotype of primary biliary cirrhosis and response to ursodeoxycholic acid. Gastroenterology. 2013;144:560-569. e7 (quiz e13\u201314).","journal-title":"Gastroenterology"},{"key":"1839_CR5","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1038\/nrgastro.2015.187","volume":"12","author":"PJ Trivedi","year":"2015","unstructured":"Trivedi PJ, Hirschfield GM. Primary biliary cirrhosis: renaming primary biliary cirrhosis-clarity or confusion? Nat Rev Gastroenterol Hepatol. 2015;12:678\u20139.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"1839_CR6","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1111\/jgh.14700","volume":"34","author":"G Semmler","year":"2019","unstructured":"Semmler G, Simbrunner B, Scheiner B, et al. Impact of farnesoid X receptor single nucleotide polymorphisms on hepatic decompensation and mortality in cirrhotic patients with portal hypertension. J Gastroenterol Hepatol. 2019;34:2164\u201372.","journal-title":"J Gastroenterol Hepatol"},{"key":"1839_CR7","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.jhep.2005.10.013","volume":"44","author":"G D\u2019Amico","year":"2006","unstructured":"D\u2019Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol. 2006;44:217\u201331.","journal-title":"J Hepatol"},{"key":"1839_CR8","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1111\/j.1365-2036.2009.04215.x","volume":"31","author":"C-W Chan","year":"2010","unstructured":"Chan C-W, Tsochatzis EA, Carpenter JR, et al. Predicting the advent of ascites and other complications in primary biliary cirrhosis: a staged model approach. Aliment Pharmacol Ther. 2010;31:573\u201382.","journal-title":"Aliment Pharmacol Ther"},{"key":"1839_CR9","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.3748\/wjg.v19.i7.1111","volume":"19","author":"T-Y Shi","year":"2013","unstructured":"Shi T-Y, Zhang L-N, Chen H, et al. Risk factors for hepatic decompensation in patients with primary biliary cirrhosis. World J Gastroenterol. 2013;19:1111\u20138.","journal-title":"World J Gastroenterol"},{"key":"1839_CR10","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1016\/j.jhep.2014.07.036","volume":"61","author":"S Joshita","year":"2014","unstructured":"Joshita S, Umemura T, Ota M, et al. AST\/platelet ratio index associates with progression to hepatic failure and correlates with histological fibrosis stage in Japanese patients with primary biliary cirrhosis. J Hepatol. 2014;61:1443\u20135.","journal-title":"J Hepatol"},{"key":"1839_CR11","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.jhep.2013.04.010","volume":"59","author":"I Patanwala","year":"2013","unstructured":"Patanwala I, McMeekin P, Walters R, et al. A validated clinical tool for the prediction of varices in PBC: the Newcastle Varices in PBC Score. J Hepatol. 2013;59:327\u201335.","journal-title":"J Hepatol"},{"key":"1839_CR12","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1056\/NEJMoa1509840","volume":"375","author":"F Nevens","year":"2016","unstructured":"Nevens F, Andreone P, Mazzella G, et al. A placebo-controlled trial of obeticholic acid in primary biliary cholangitis. N Engl J Med. 2016;375:631\u201343.","journal-title":"N Engl J Med"},{"key":"1839_CR13","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1055\/s-0036-1597891","volume":"37","author":"JG Abraldes","year":"2017","unstructured":"Abraldes JG, Garcia-Tsao G. The design of clinical trials in portal hypertension. Semin Liver Dis. 2017;37:73\u201384.","journal-title":"Semin Liver Dis"},{"key":"1839_CR14","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1002\/hep.27583","volume":"61","author":"JG Abraldes","year":"2015","unstructured":"Abraldes JG, Tandon P. Soft and hard endpoints in acute variceal bleeding. Hepatology. 2015;61:762\u20135.","journal-title":"Hepatology"},{"key":"1839_CR15","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1055\/s-2007-1011931","volume":"7","author":"K Frank","year":"1986","unstructured":"Frank K, Linhart P, Kortsik C, et al. Sonographic determination of spleen size: normal dimensions in adults with a healthy spleen. Ultraschall Med. 1986;7:134\u20137.","journal-title":"Ultraschall Med"},{"key":"1839_CR16","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1148\/radiol.2019190734","volume":"294","author":"N Bastati","year":"2020","unstructured":"Bastati N, Beer L, Mandorfer M, et al. Does the functional liver imaging score derived from gadoxetic acid-enhanced MRI predict outcomes in chronic liver disease? Radiology. 2020;294:98\u2013107.","journal-title":"Radiology"},{"key":"1839_CR17","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/liv.13943","volume":"39","author":"B Scheiner","year":"2019","unstructured":"Scheiner B, Steininger L, Semmler G, et al. Controlled attenuation parameter does not predict hepatic decompensation in patients with advanced chronic liver disease. Liver Int. 2019;39:127\u201335.","journal-title":"Liver Int"},{"key":"1839_CR18","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1111\/liv.14498","volume":"40","author":"B Simbrunner","year":"2020","unstructured":"Simbrunner B, Marculescu R, Scheiner B, et al. Non-invasive detection of portal hypertension by enhanced liver fibrosis score in patients with different aetiologies of advanced chronic liver disease. Liver Int. 2020;40:1713\u201324.","journal-title":"Liver Int"},{"key":"1839_CR19","first-page":"e58819","volume":"160","author":"T Reiberger","year":"2020","unstructured":"Reiberger T, Schwabl P, Trauner M, et al. Measurement of the hepatic venous pressure gradient and transjugular liver biopsy. JoVE (J Vis Exp). 2020;160:e58819.","journal-title":"JoVE (J Vis Exp)"},{"key":"1839_CR20","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1111\/liv.12623","volume":"35","author":"P Schwabl","year":"2015","unstructured":"Schwabl P, Bota S, Salzl P, et al. New reliability criteria for transient elastography increase the number of accurate measurements for screening of cirrhosis and portal hypertension. Liver Int. 2015;35:381\u201390.","journal-title":"Liver Int"},{"key":"1839_CR21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1007\/s00508-012-0190-5","volume":"124","author":"T Reiberger","year":"2012","unstructured":"Reiberger T, Ferlitsch A, Payer BA, et al. Noninvasive screening for liver fibrosis and portal hypertension by transient elastography\u2014a large single center experience. Wien Klin Wochenschr. 2012;124:395\u2013402.","journal-title":"Wien Klin Wochenschr"},{"key":"1839_CR22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1007\/s00508-017-1262-3","volume":"129","author":"T Reiberger","year":"2017","unstructured":"Reiberger T, P\u00fcsp\u00f6k A, Schoder M, et al. Austrian consensus guidelines on the management and treatment of portal hypertension (Billroth III). Wien Klin Wochenschr. 2017;129:135\u201358.","journal-title":"Wien Klin Wochenschr"},{"key":"1839_CR23","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1016\/j.jhep.2021.04.010","volume":"75","author":"A Tanaka","year":"2021","unstructured":"Tanaka A, Hirohara J, Nakano T, et al. Association of bezafibrate with transplant-free survival in patients with primary biliary cholangitis. J Hepatol. 2021;75:565\u2013571.","journal-title":"J Hepatol"},{"key":"1839_CR24","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1007\/s00535-003-1196-6","volume":"38","author":"E Takeshita","year":"2003","unstructured":"Takeshita E, Kumagi T, Matsui H, et al. Esophagogastric varices as a prognostic factor for the determination of clinical stage in patients with primary biliary cirrhosis. J Gastroenterol. 2003;38:1060\u20135.","journal-title":"J Gastroenterol"},{"key":"1839_CR25","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","volume":"63","author":"de Franchis R, Baveno VI Faculty","year":"2015","unstructured":"de Franchis R, Baveno VI Faculty. Expanding consensus in portal hypertension: report of the Baveno VI consensus workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol. 2015;63:743\u201352.","journal-title":"J Hepatol"},{"key":"1839_CR26","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1038\/s41395-018-0265-7","volume":"114","author":"C Moctezuma-Velazquez","year":"2019","unstructured":"Moctezuma-Velazquez C, Saffioti F, Tasayco-Huaman S, et al. Non-invasive prediction of high-risk varices in patients with primary biliary cholangitis and primary sclerosing cholangitis. Am J Gastroenterol. 2019;114:446\u201352.","journal-title":"Am J Gastroenterol"},{"issue":"55","key":"1839_CR27","first-page":"449","volume":"021","author":"KT Osman","year":"2020","unstructured":"Osman KT, Maselli DB, Idilman IS, et al. Liver stiffness measured by either magnetic resonance or transient elastography is associated with liver fibrosis and is an independent predictor of outcomes among patients with primary biliary cholangitis. J Clin Gastroenterol. 2020;021(55):449\u201357.","journal-title":"J Clin Gastroenterol."},{"key":"1839_CR28","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1016\/S0140-6736(18)31875-0","volume":"393","author":"C Villanueva","year":"2019","unstructured":"Villanueva C, Albillos A, Genesc\u00e0 J, et al. \u03b2 blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019;393:1597\u2013608.","journal-title":"Lancet"},{"key":"1839_CR29","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1016\/j.jhep.2012.12.011","volume":"58","author":"T Reiberger","year":"2013","unstructured":"Reiberger T, Ferlitsch A, Payer BA, et al. Non-selective betablocker therapy decreases intestinal permeability and serum levels of LBP and IL-6 in patients with cirrhosis. J Hepatol. 2013;58:911\u201321.","journal-title":"J Hepatol"},{"key":"1839_CR30","doi-asserted-by":"publisher","first-page":"1634","DOI":"10.1136\/gutjnl-2012-304038","volume":"62","author":"T Reiberger","year":"2013","unstructured":"Reiberger T, Ulbrich G, Ferlitsch A, et al. Carvedilol for primary prophylaxis of variceal bleeding in cirrhotic patients with haemodynamic non-response to propranolol. Gut. 2013;62:1634\u201341.","journal-title":"Gut"},{"key":"1839_CR31","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.jhep.2016.11.001","volume":"66","author":"T Reiberger","year":"2017","unstructured":"Reiberger T, Mandorfer M. Beta adrenergic blockade and decompensated cirrhosis. J Hepatol. 2017;66:849\u201359.","journal-title":"J Hepatol"},{"key":"1839_CR32","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1111\/liv.13615","volume":"38","author":"T Bucsics","year":"2018","unstructured":"Bucsics T, Hoffman S, Gr\u00fcnberger J, et al. ePTFE-TIPS vs repetitive LVP plus albumin for the treatment of refractory ascites in patients with cirrhosis. Liver Int. 2018;38:1036\u201344.","journal-title":"Liver Int"},{"key":"1839_CR33","doi-asserted-by":"publisher","first-page":"e0189414","DOI":"10.1371\/journal.pone.0189414","volume":"13","author":"T Bucsics","year":"2018","unstructured":"Bucsics T, Schoder M, Diermayr M, et al. Transjugular intrahepatic portosystemic shunts (TIPS) for the prevention of variceal re-bleeding\u2014a two decades experience. PLoS\u00a0One. 2018;13:e0189414.","journal-title":"PLoS\u00a0One"},{"key":"1839_CR34","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1053\/j.gastro.2016.09.016","volume":"152","author":"C Bureau","year":"2017","unstructured":"Bureau C, Thabut D, Oberti F, et al. Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology. 2017;152:157\u201363.","journal-title":"Gastroenterology"},{"key":"1839_CR35","doi-asserted-by":"publisher","first-page":"2370","DOI":"10.1056\/NEJMoa0910102","volume":"362","author":"JC Garc\u00eda-Pag\u00e1n","year":"2010","unstructured":"Garc\u00eda-Pag\u00e1n JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med. 2010;362:2370\u20139.","journal-title":"N Engl J Med"},{"key":"1839_CR36","doi-asserted-by":"publisher","first-page":"1913","DOI":"10.14309\/ajg.0000000000001280","volume":"116","author":"BV John","year":"2021","unstructured":"John BV, Khakoo NS, Schwartz KB, et al. Ursodeoxycholic acid response is associated with reduced mortality in primary biliary cholangitis with compensated cirrhosis. Am J Gastroenterol. 2021;116:1913\u201323.","journal-title":"Am J Gastroenterol."},{"key":"1839_CR37","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.1136\/gutjnl-2017-315259","volume":"67","author":"GM Hirschfield","year":"2018","unstructured":"Hirschfield GM, Dyson JK, Alexander GJM, et al. The British Society of Gastroenterology\/UK-PBC primary biliary cholangitis treatment and management guidelines. Gut. 2018;67:1568\u201394.","journal-title":"Gut"},{"key":"1839_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/hep.1840100102","volume":"10","author":"ER Dickson","year":"1989","unstructured":"Dickson ER, Grambsch PM, Fleming TR, et al. Prognosis in primary biliary cirrhosis: model for decision making. Hepatology. 1989;10:1\u20137.","journal-title":"Hepatology"},{"key":"1839_CR39","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1002\/hep.510280203","volume":"28","author":"O Chazouill\u00e8res","year":"1998","unstructured":"Chazouill\u00e8res O, Wendum D, Serfaty L, et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: clinical features and response to therapy. Hepatology. 1998;28:296\u2013301.","journal-title":"Hepatology"},{"key":"1839_CR40","doi-asserted-by":"publisher","first-page":"1449","DOI":"10.3390\/jcm9051449","volume":"9","author":"BL Freedman","year":"2020","unstructured":"Freedman BL, Danford CJ, Patwardhan V, et al. Treatment of overlap syndromes in autoimmune liver disease: a systematic review and meta-analysis. J Clin Med. 2020;9:1449.","journal-title":"J Clin Med"},{"key":"1839_CR41","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1016\/j.jhep.2010.09.002","volume":"54","author":"KM Boberg","year":"2011","unstructured":"Boberg KM, Chapman RW, Hirschfield GM, et al. Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue. J Hepatol. 2011;54:374\u201385.","journal-title":"J Hepatol"},{"key":"1839_CR42","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.biocel.2017.11.011","volume":"94","author":"CV McKenzie","year":"2018","unstructured":"McKenzie CV, Colonne CK, Yeo JH, et al. Splenomegaly: pathophysiological bases and therapeutic options. Int J Biochem Cell Biol. 2018;94:40\u20133.","journal-title":"Int J Biochem Cell Biol"},{"key":"1839_CR43","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1111\/j.1440-1827.1994.tb02922.x","volume":"44","author":"N Terayama","year":"1994","unstructured":"Terayama N, Makimoto KP, Kobayashi S, et al. Pathology of the spleen in primary biliary cirrhosis: an autopsy study. Pathol Int. 1994;44:753\u20138.","journal-title":"Pathol Int"},{"key":"1839_CR44","doi-asserted-by":"publisher","first-page":"24","DOI":"10.2188\/jea.15.24","volume":"15","author":"F Sakauchi","year":"2005","unstructured":"Sakauchi F, Mori M, Zeniya M, et al. A cross-sectional study of primary biliary cirrhosis in Japan: utilization of clinical data when patients applied to receive public financial aid. J Epidemiol. 2005;15:24\u20138.","journal-title":"J Epidemiol"},{"key":"1839_CR45","doi-asserted-by":"publisher","first-page":"2613","DOI":"10.1016\/j.cgh.2018.12.033","volume":"17","author":"F Jung","year":"2019","unstructured":"Jung F, Cazzagon N, Vettorazzi E, et al. Rate of spleen length progression is a marker of outcome in patients with primary sclerosing cholangitis. Clin Gastroenterol Hepatol. 2019;17:2613\u20135.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"1839_CR46","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/1319-3767.164185","volume":"22","author":"S Ramanathan","year":"2016","unstructured":"Ramanathan S, Khandelwal N, Kalra N, et al. Correlation of HVPG level with ctp score, MELD score, ascites, size of varices, and etiology in cirrhotic patients. Saudi J Gastroenterol. 2016;22:109\u201315.","journal-title":"Saudi J Gastroenterol"},{"key":"1839_CR47","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1111\/jgh.14514","volume":"34","author":"M-A Aller","year":"2019","unstructured":"Aller M-A, Arias N, Blanco-Rivero J, et al. Hepatic encephalopathy: sometimes more portal than hepatic. J Gastroenterol Hepatol. 2019;34:490\u20134.","journal-title":"J Gastroenterol Hepatol"},{"key":"1839_CR48","doi-asserted-by":"publisher","first-page":"1510","DOI":"10.1002\/hep4.1425","volume":"3","author":"EB Tapper","year":"2019","unstructured":"Tapper EB, Henderson JB, Parikh ND, et al. Incidence of and risk factors for hepatic encephalopathy in a population-based cohort of Americans with cirrhosis. Hepatology Commun. 2019;3:1510\u20139.","journal-title":"Hepatology Commun"}],"container-title":["Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-021-01839-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00535-021-01839-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-021-01839-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T23:36:02Z","timestamp":1699918562000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00535-021-01839-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,11]]},"references-count":48,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["1839"],"URL":"https:\/\/doi.org\/10.1007\/s00535-021-01839-3","relation":{},"ISSN":["0944-1174","1435-5922"],"issn-type":[{"value":"0944-1174","type":"print"},{"value":"1435-5922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,11]]},"assertion":[{"value":"5 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr Burghart, Dr Halilbasic, Dr Petrenko and Dr Boztug declare no conflict of interest. Dr Schwabl received speaking honoraria from Bristol-Myers Squibb and Boehringer-Ingelheim, consulting fees from PharmaIN and travel support from Falk. Dr Simbrunner received travel support from Abbvie and Gilead. Dr St\u00e4ttermayer consults for, advises, and\/or is on the speakers\u2019 bureau for Boehringer Ingelheim, Gilead, and MSD. Dr Scheiner received travel support from Abbvie, Gilead and Ipsen. Dr Bauer received travel support from Abbvie and Gilead and has received speaker fees from Abbvie. Dr Mandorfer consults for, advises, is on the speakers\u2019 bureau for, and\/or received travel support from AbbVie, Bristol\u2010Myers Squibb, and Gilead. He consults for, advises, and\/or is on the speakers\u2019 bureau for W.L. Gore & Associates. Dr Pinter is an investigator for Bayer, BMS, Lilly, and Roche; he received speaker honoraria from Bayer, BMS, Eisai, Lilly, and MSD; he is a consultant for Bayer, BMS, Ipsen, Eisai, Lilly, MSD, and Roche; he received travel support from Bayer and BMS. Prof Trauner received grant support from Albireo, Cymabay, Falk, Gilead, Intercept, MSD, and Takeda, honoraria for consulting from BiomX, Boehringer Ingelheim, Falk, Genfit, Gilead, Intercept, Janssen, MSD, Novartis, Phenex, and Regulus, speaker fees from BMS, Falk, Gilead, Intercept and MSD, as well as travel support from Abbvie, Falk, Gilead and Intercept. Prof Reiberger received grant support from Abbvie, Boehringer-Ingelheim, Gilead, MSD, Philips Healthcare, Gore; speaking honoraria from Abbvie, Gilead, Gore, Intercept, Roche, MSD; consulting\/advisory board fee from Abbvie, Bayer, Boehringer-Ingelheim, Gilead, Intercept, MSD, Siemens; and travel support from Boehringer-Ingelheim, Gilead and Roche.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}