Jose Ignacio (Iñaki) Fortea

MD, PhD. Gastroenterology and Hepatology Department. University Hospital Marqués de Valdecilla. @DigValdecilla. @HUnivValdecilla @IDIVALdireccion

[Asociación Española para el Estudio del Hígado @AEEHLiver]

🧑‍💻¿Te perdiste nuestro último webinar del Registro #ReHeVasc?
💫¡Fue todo un éxito, con 480 conectados!
🗣️ Hablamos sobre avances en el manejo de las enfermedades vasculares hepáticas, dándole visibilidad a un tipo de patologías infradiagnosticadas y desconocidas. ¡Puedes volver a verlo en nuestro canal YouTube! ⬇️⬇️

https://t.co/2lGtuW76Yd

[Javier Ampuero @Dr_Ampuero]

Delighted to share our latest paper in @NatRevGastroHep, emphasizing that MASLD requires an integrated approach combining fibrosis stage and metabolic risk factors in real-world practice.

https://t.co/AXC8uJa6T4

@AEEHLiver @sepdigestiva @HospitalUVRocio @ibis_sevilla @EASLnews

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Underdilated TIPS (≤7mm) in refractory ascites
🗣️ D. Saltini | #EASLCongress
🔬 ↓ mortality & ↓ OHE — similar ascites control
⚠️ Dilation diameter = key modifiable determinant — not hemodynamic targets
💡 Step-up strategy: start with under-dilation

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 Ongoing Phase III RCTs in ascites & HRS
🗣️ C. Ripoll | #EASLCongress
🔬 Ongoing trials:
- Ascites → ALBTRIAL | eTIPS (early TIPS vs SOC)
- HRS-AKI → Ambrisentan/ET-A antagonist | OCE-205 | Liver-HERO (TIPS)
- SGLT-2 inhibitors also under investigation

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 Infection & HE in cirrhosis
🗣️ T. Thévenot | #EASLCongress
🔬 Rifaximin & cotrimoxazole (ASEPTIC trial) for 1 PF SBP prophylaxis → no benefit — Baveno VIII agrees
⚠️ Antibiotic prophylaxis in GI bleeding also questioned in Child-Pugh A pts
💡 Future: albumin, probiotics & FMT

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 Ongoing Phase III RCTs in ACLF
🗣️ J. Fernández | #EASLCongress
🔬 Key results:
- G-CSF → conflicting (✅ India vs ❌ Europe)
- DIALIVE, ELAD & plasma exchange → more data needed
💡 New trial designs (DOOR, adaptive) needed — esp. severe ACLF (≥3 OF)

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 CKD predicts worse outcomes after TIPS for ascites
🗣️ @luistevilla | #EASLCongress

Key results (EuroTIPS cohort, n=653):
🔬 CKD → ↑ mortality (aHR 2.26) & ↑ persistent ascites (aRR 3.35)
⚠️ MASH+CKD = extreme risk: aRR 7.06!
💡 Screen for CKD before TIPS

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 New multisociety consensus on PSVD
🗣️ L. Elkrief | #EASLCongress
🔬 PSVD & NCPF now interchangeable
⚠️ Biopsy mandatory | can be diagnosed WITHOUT portal hypertension
💡 First globally endorsed framework (EASL/AASLD/APASL/ALEH)
🔗 https://t.co/aO1PaWIuN0

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 Post-TIPS heart failure (EuroTIPS)
🗣️ @anna_baiges | #EASLCongress
🔬 HF in 11% — Toulouse algorithm ❌ fails in real-world
🆕 EuroTIPS HF score (NT-proBNP, MetSyn, Na⁺, sex) → high risk 45% vs 3% (validated n=824)
⚠️ Check cardiac biomarkers BEFORE TIPS!

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 TIPS in PSVD
🗣️ @marcosenzolo | #EASLCongress
🔬 Bleeding control 92.4% | Ascites control 71.2%
🔎 Underdilated TIPS (<8mm) → same control & survival but ↓ oHE (10.5% vs 26.3%)
⚠️ Different predictors by indication
💡 Underdilation strategy preferred in PSVD

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

🧫 Ongoing Phase III RCTs in variceal bleeding & cirrhosis
🗣️ @DTrip2015 | #EASLCongress

🔬 Ongoing trials:
- NSBB → BOPPP (carvedilol vs placebo, small varices) & CROSBY (carvedilol ± EVL)
- pTIPSS → REACT-AVB (early pTIPSS vs SOC)
- APEACH (apixaban) | SACRED (simvastatin)

[José Presa @JosPresa3]

Start EASL/Baveno Symposium with 🇵🇹✨ @RodriguesSu24

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Anticoagulation in cirrhosis & invasive procedures 🗣️ L. Elkrief | #EASLCongress
💡 Similar to general population — assess:
🔬 Procedure bleeding risk
🩸 Thrombotic risk
🚨 Urgent vs elective

AND cirrhosis severity + infection, AKI… → defer if possible

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Anticoagulation for PVT in cirrhosis
🗣️ N. Riva |
💡 Treat based on: LT candidacy, thrombus extension & cirrhosis severity
🔬 DOACs in cirrhosis:
✅ Child A → all DOACs OK
⚠️ Child B → apixaban/edoxaban with caution, avoid rivaroxaban
❌ Child C → avoid all DOACs

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Anticoagulation to prevent decompensation in cirrhosis
🗣️ A. Puente | #EASLCongress
🔬 Parenchymal extinction & PAR receptors → ↑ PH & fibrosis
⚠️ Cirroxaban: NS trend — benefit in Child B-7
💡 Guidelines -> No support yet
🚀 APEACH & FXI antagonists may change the game

[Asociación Española para el Estudio del Hígado @AEEHLiver]

Intervención de Ángela Puente, vicesecretaria de la #AEEH, en el #EASL2026Congress. 👏👏👏

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

💙 Remembering Jaume Bosch | #EASLCongress
🗣️ Beautiful tribute by @ggarciatsao
🔬 One of the Baveno founders & a giant of PH
🌍 Mentor, collaborator & citizen of the world
💡 "Your legacy lives on — in the questions we ask, in the way we work" — @JSGracia, Baveno VIII

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 NITs in defining CSPH — Baveno VIII
🗣️ @RodriguesSu24 | #EASLCongress

Key messages:
🔬 LSM + ANTICIPATE → mainstay of CSPH diagnosis ⚠️ Repeat NITs every 12 m — most recent value wins
💡 SSM + biomarkers reduce the CSPH grey zone
🚀 Future: AI-driven multimodal assessment

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Preventing decompensation in cACLD — Baveno VIII 🗣️ @bogdanprocopet | #EASLCongress
🔬 PH = main driver of decompensation
⚠️ Ascites = most common & deadliest event
💡 Treat the etiology → ↓PH → ↓decompensation risk
💊 NSBBs (carvedilol) → ↓ decompensation (ascites)

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 TIPS for refractory hepatic hydrothorax — multicenter European cohort
🗣️ C. Alessandria | #EASLCongress
🔬 Complete response (CR) in 60% → ↑ survival
⚠️ No variable predicted CR — still hard to select the right patient
🩺 TIPS: a valuable option for refractory hydrothorax