Ferrarese A, Zanetto A, Germani G, Burra P, Senzolo M. Rethinking the role of non-selective beta blockers in patients with cirrhosis and portal hypertension. World J Hepatol 2016; 8(24): 1012-1018 [PMID: 27648153 DOI: 10.4254/wjh.v8.i24.1012]
Corresponding Author of This Article
Dr. Marco Senzolo, MD, PhD, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, via Giustiniani 2, 35128 Padua, Italy. marcosenzolo@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 28, 2016; 8(24): 1012-1018 Published online Aug 28, 2016. doi: 10.4254/wjh.v8.i24.1012
Rethinking the role of non-selective beta blockers in patients with cirrhosis and portal hypertension
Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo
Alberto Ferrarese, Alberto Zanetto, Giacomo Germani, Patrizia Burra, Marco Senzolo, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy
Author contributions: Ferrarese A wrote and reviewed the manuscript; Zanetto A and Germani G edited the manuscript; Burra P and Senzolo M supervised, drafted and reviewed the manuscript.
Conflict-of-interest statement: The authors do not have anything to disclose about this paper. The authors did not receive any funding for producing the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Marco Senzolo, MD, PhD, Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, via Giustiniani 2, 35128 Padua, Italy. marcosenzolo@hotmail.com
Telephone: +39-04-98218726 Fax: +39-04-98218727
Received: April 30, 2016 Peer-review started: May 3, 2016 First decision: June 17, 2016 Revised: July 1, 2016 Accepted: July 14, 2016 Article in press: July 18, 2016 Published online: August 28, 2016 Processing time: 117 Days and 9.7 Hours
Abstract
Non-selective beta blockers (NSBB) are commonly used to prevent portal hypertensive bleeding in cirrhotics. Nevertheless, in the last years, the use of NSBB in critically decompensated patients, especially in those with refractory ascites, has been questioned, mainly for an increased risk of mortality and worsening of systemic hemodynamics. Moreover, even if NSBB have been reported to correlate with a higher risk of renal failure and severe infection in patients with advanced liver disease and hypotension, their use has been associated with a reduction of risk of spontaneous bacterial peritonitis, modification of gut permeability and reduction of bacterial translocation. This manuscript systematically reviews the published evidences about harms and benefits of the use of NSBB in patients with decompensated cirrhosis.
Core tip: In this review, we’ve critically analyzed the recent evidence on the role played by non-selective beta blockers in patients with decompensated liver disease.
