IMPPHR Executive Committee
Oanez Ackermann, MD
Pediatrician
Practitioner, Pediatric Hepatology and Liver Transplantation
Bicetre Hospital, Assistance Publique-Hôpitaux de Paris
Paris-Saclay University, France
Oanez Ackermann is a physician who has worked for many years in the pediatric hepatology team at Bicêtre, the French reference center for pediatric liver diseases. She has long been interested in the management of portal hypertension in children. She is the head of the pediatric endoscopy unit in Bicêtre. She is involved in the coordination of the French reference center for pediatric vascular liver diseases.
Relevant References- Duché M, Ducot B, Ackermann O, Baujard C, Chevret L, Frank-Soltysiak M, Jacquemin E, Bernard O. Experience with endoscopic management of high-risk gastroesophageal varices, with and without bleeding, in children with biliary atresia. Gastroenterology. 2013 Oct;145(4):801-7.
- Duché M, Ducot B, Ackermann O, Jacquemin E, Bernard O. Progression to high-risk gastroesophageal varices in children with biliary atresia with low-risk signs at first endoscopy. J Pediatr Gastroenterol Nutr. 2015 May;60(5):664-8.
- Duché M, Ducot B, Ackermann O, Guérin F, Jacquemin E, Bernard O. Portal hypertension in children: High-risk varices, primary prophylaxis and consequences of bleeding. J Hepatol. 2017 Feb;66(2):320-327.
- Ackermann O, de Boissieu P, Bernard O, Gonzales E, Jacquemin E, Duché M. A Model for Early Endoscopic Detection of High-Risk Gastroesophageal Varices in Children With Biliary Atresia. J Pediatr Gastroenterol Nutr. 2022 May 1;74(5):643-650
- Ackermann O, Darmellah-Remil A, Bernard O, Boytchev I, Staiti G, Gonzalès E, Jacquemin E, Duché M. Efficacy and safety of endoscopic primary prophylaxis of bleeding in children with high-risk gastroesophageal varices. J Pediatr Gastroenterol Nutr. 2022 Oct 1;75(4):491-496
Jaime Bosch, MD, PhD, FRCP, FAASLD
Emeritus Professor of Medicine, University of Barcelona (Spain)
Guest Professor of Hepatology, Inselspital, Bern University Hospital, Bern (Switzerland).
Dr Bosch interest in portal hypertension was inspired by a fellowship with Dr Roberto Groszmann at Yale University (1980-82) with whom he continued a life-long cooperation. Back in Barcelona, Dr Bosch was the founder of the Hepatic Hemodynamic Laboratory at the Hospital Clinic where over 100 international fellows have trained under his guidance and over 50 PhD students completed their Thesis.
Main topics in his career have been the study of the pathophysiology of portal hypertension and development of new pharmacological treatments, from the use of terlipressin, somatostatin and octreotide for variceal bleeding, to the use of non-selective beta-blockers and carvedilol for the prevention of first and recurrent variceal bleeding, and for the prevention of the decompensation of cirrhosis. His team has also introduced the use of statins for portal hypertension, organ preservation and prevention of acute-on-chronic liver failure, and developed and characterized several animal models of cirrhosis and NASH. Dr Bosch, together with Drs R DeFranchis, AK Burroughs and RJ Groszmann was a founder of the International Baveno Consensus Conferences on Portal Hypertension and is the current President of the Baveno Cooperation: a EASL Consortium. He has been awarded Special Recognition Award by the European Association for the Study of the Liver, the Gold Medal of the Canadian Association for the Study of Liver Diseases and the Spain Association for the Study of the Liver, and has been nominated Doctor Honoris Causa by the Universities of Toulouse (France) and Cluj-Napoca (Romania). Dr Bosch has published 572 papers indexed in PubMed, with an H-Index of 123.
Relevant References- Groszmann RJ, Garcia-Tsao G, Bosch J, Grace ND, Burroughs AK, et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med. 2005 Nov 24;353(21):2254-61. PMID: 16306522.
- García-Pagán JC, Caca K, Bureau C, Laleman W, Appenrodt B, Luca A, Abraldes JG, Nevens F, Vinel JP, Mössner J, and Bosch J. Early use of TIPS in patients with cirrhosis and variceal bleeding. N Engl J Med. 2010 Jun 24;362(25):2370-9. PMID: 20573925.
- Garcia-Tsao G, Bosch J. Management of varices and variceal hemorrhage in cirrhosis. N Engl J Med. 2010 Mar 4;362(9):823-32. PMID: 20200386.
- Villanueva C, Albillos A, Genescà J, Garcia-Pagan JC, Calleja JL, Aracil C, Bañares R, Morillas RM, Poca M, Peñas B, Augustin S, Abraldes JG, Alvarado E, Torres F, Bosch J. β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2019 Apr 20;393(10181):1597-1608. PMID: 30910320.
- Tsochatzis EA, Bosch J, Burroughs AK. Liver cirrhosis. Lancet. 2014 May 17;383(9930):1749-61. PMID: 24480518.
- Feu F, García-Pagán JC, Bosch J, et al. Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet. 1995 Oct 21;346(8982):1056-9. PMID: 7564785.
- Bosch J, Gracia-Sancho J, Abraldes JG. Cirrhosis as new indication for statins. Gut. 2020 May;69(5):953-962. PMID: 32139553.
- Shneider BL, de Ville de Goyet J, Leung DH, Srivastava A, Ling SC, Duché M, McKiernan P, Superina R, Squires RH, Bosch J, Groszmann R, Sarin SK, de Franchis R, Mazariegos GV. Primary prophylaxis of variceal bleeding in children and the role of MesoRex Bypass: Summary of the Baveno VI Pediatric Satellite Symposium. Hepatology. 2016 Apr;63(4):1368-80 PMID: 26358549.
- de Franchis R, Bosch J, Garcia-Tsao G, Reiberger T, Ripoll C; Baveno VII Faculty. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-974. PMID: 35120736.
Roberto De Franchis (Milan, Italy)
Dr Tassos Grammatikopoulos MDRes, FRCPCH
Consultant in Paediatric Hepatology & Honorary Clinical Senior Lecturer
Chair of BSPGHAN Liver Steering Group
Chair of ESPGHAN Portal Hypertension Special Interest Group
Paediatric Liver, GI & Nutrition Centre
King's College Hospital, London, UK
King's College London, UK
Dr Tassos Grammatikopoulos is a Consultant in Paediatric Hepatology at King's College Hospital, London, UK.
He has graduated from the Aristotle University Medical School in Thessaloniki, Greece and completed his general paediatric and paediatric Hepatology training in the UK. He has been awarded the Alex Mowat Prize (ESPGHAN 2006/ BSPGHAN 2021) and the Rising Star Award (ILTS 2008) for his research work. He has a special interest in portal hypertension and cholestasis. He is lead for the paediatric portal hypertension service at King's College Hospital. He is a member of the BAVENO paediatric symposium executive committee. He has been promoting topics on paediatric portal hypertension and leading several initiatives at national and international level.
He has conducted various laboratory and clinical research projects and authored a number of original research papers on portal hypertension.
Relevant References- Use and safety of prophylactic endoscopy from a single center serving urban and rural children with portal hypertension. Slowik V, Bernardez A, Wasserkrug H, Fischer RT, Daniel JF, Grammatikopoulos T.Sci Rep. 2022 Jan 7;12(1):25. doi: 10.1038/s41598-021-03759-x.PMID: 34996951
- Optimal timing of endoscopy in pediatric variceal hemorrhage - How urgent is urgent? Slowik V, Grammatikopoulos T.Dig Liver Dis. 2022 Jan;54(1):1-2. doi: 10.1016/j.dld.2021.10.009. Epub 2021 Nov 12.PMID: 34782278
- Transient Elastography Measurements of Spleen Stiffness as a Predictor of Clinically Significant Varices in Children. Sutton H, Fitzpatrick E, Davenport M, Burford C, Alexander E, Dhawan A, Grammatikopoulos T. J Pediatr Gastroenterol Nutr. 2018 Oct;67(4):446-451. doi: 10.1097/MPG.0000000000002069.
- Non-invasive Markers of Portal Hypertension: Appraisal of Adult Experience and Potential Utilisation in Children. Sutton H, Dhawan A, Grammatikopoulos T. J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):559-569. doi: 10.1097/MPG.0000000000001882.
- Portal hypertension and its management in children. Grammatikopoulos T, McKiernan PJ, Dhawan A. Arch Dis Child. 2018 Feb;103(2):186-191. doi: 10.1136/archdischild-2015-310022. Epub 2017 Aug 16.
- King's Variceal Prediction Score: A Novel Noninvasive Marker of Portal Hypertension in Pediatric Chronic Liver Disease. Witters P, Hughes D, Karthikeyan P,Ramakrishna S,Davenport M, Dhawan A, Grammatikopoulos T. J Pediatr Gastroenterol Nutr. 2017 Apr;64(4):518-523. doi: 10.1097/MPG.0000000000001423.
- Prediction of esophageal varices in biliary atresia: Derivation of the "varices prediction rule", a novel noninvasive predictor. Isted A, Grammatikopoulos T, Davenport M. J Pediatr Surg. 2015 Oct;50(10):1734-8. doi: 10.1016/j.jpedsurg.2015.02.007. Epub 2015 Feb 17.
Simon C. Ling, MBChB
Professor of Paediatrics
Division of Gastroenterology, Hepatology & Nutrition
Department of Paediatrics
The Hospital for Sick Children
University of Toronto
Toronto, Ontario, Canada
Dr. Simon Ling is an academic clinician in pediatric hepatology whose clinical research aims to improve understanding of optimal management for children with portal hypertension. His previous studies have investigated the non-invasive diagnosis of varices in children, and management of acute variceal bleeding. He has contributed to previous Baveno workshops and co-authored clinical practice guidelines for the management of ascites and for advanced cystic fibrosis liver disease. He also collaborates in studies of CF liver disease and chronic viral hepatitis in children.
Relevant References- Serrano CA, Ling SC, Verdaguer S, Leon M, Jarufe N, Guerra JF, Pattillo JC, Benitez C, Torres AV, Concha M, Villaroel L, Dellepiane P, Dominguez MP, Martinez J, Gana JC. Portal Angiogenesis in Chronic Liver Disease Patients Correlates with Portal Pressure and Collateral Formation. Digestive Diseases 2019;37(6):498-508.
- Carneiro de Moura M, Chen S, Kamath BM, Ng VL, Ling SC. Acute variceal bleeding causes significant morbidity. Journal of Pediatric Gastroenterology and Nutrition. 2018 Sep;67(3):371-376.
- Stonebraker J, Ooi C, Pace R, Corvol H, Knowles M, Durie P, Ling SC. Features of severe liver disease with portal hypertension in patients with cystic fibrosis. Clinical Gastroenterology and Hepatology August 2016;14(8):1207-1215.
- Woolfson J, John P, Kamath B, Ng VL, Ling SC. Measurement of hepatic venous pressure gradient is feasible and safe in children. Journal of Pediatric Gastroenterology and Nutrition 2013;57(5):634-7.
- Gana JC, Turner D, Mieli-Vergani G, Davenport M, Miloh T, Avitzur Y, Yap J, Morinville V, Brill H, Ling SC. A Clinical Prediction Rule and Platelet Count Predict Esophageal Varices in Children. Gastroenterology 2011; 141(6): 2009-16.
- Gana JC, Valentino P, Morinville V, O'Connor C, Ling SC: Variation in care for children with esophageal varices: a study of physicians, patients and families approaches and attitudes. Journal of Pediatric Gastroenterology Nutrition 2011: 52: pp 751-755.
Jean P. Molleston, MD
Professor of Clinical Pediatrics - Indiana University School of Medicine
Professor of Clinical Medicine - Indiana University School of Medicine
Division Chief, Pediatric Gastroenterology, Hepatology and Nutrition
Medical Director, Pediatric Liver Transplant Program
I am a pediatric hepatologist, clinical researcher, medical educator, and Chief of the Division of Pediatric Gastroenterology, Hepatology, and Nutrition at Indiana University School of Medicine. I have nearly 30 years of experience managing and studying children with gastrointestinal and liver diseases. I have participated in U01 multicenter research networks studying fatty liver in children (NASH CRN), cholestatic liver disease in children (CHiLDReN NIH U01), cystic fibrosis liver disease (CFLD), and drug-induced liver injury (DILIN NIH U01). I have extensive experience recruiting children with advanced liver disease into large research networks and studying pathophysiology of pediatric liver disease. I have had a long-term clinical and research interest in cirrhosis and portal hypertension in children, with focus on variceal bleeding, mortality, and other long-term outcomes.
I have been actively involved in medical education at the undergraduate, graduate, and post-doctoral levels of medical school and have mentored students, residents, fellows, and junior faculty in clinical research.
Relevant References- Bass LM, Ye W, Hawthorne K, Leung DH, Murray KF, Molleston JP, Romero R, Karpen S, Rosenthal P, Loomes KM, Wang KS, Squires RH, Miethke A, Ng VL, Horslen S, Kyle Jensen M, Sokol RJ, Magee JC, Shneider BL; ChiLDReN. Risk of variceal hemorrhage and pretransplant mortality in children with biliary atresia. Hepatology. 2022 Sep;76(3):712-726. doi: 10.1002/hep.32451. Epub 2022 Apr 18. PMID: 35271743; PMCID: PMC9378352.
- Leung DH, Devaraj S, Goodrich NP, Chen X, Rajapakshe D, Ye W, Andreev V, Minard CG, Guffey D, Molleston JP, Bass LM, Karpen SJ, Kamath BM, Wang KS, Sundaram SS, Rosenthal P, McKiernan P, Loomes KM, Jensen MK, Horslen S, Bezerra JA, Magee JC, Merion RM, Sokol RJ, Shneider BL, for ChiLDReN. Serum Biomarkers Correlated with Liver Stiffness Assessed in a Multi-center Study of Pediatric Cholestatic Liver Disease. Hepatology. 2022 Sep 7. Doi:10.1002/hep.32777. Epub ahead of print.
- Gawrieh S, Harlow KE, Pike F, Yates KP, Wilson LA, Cummings OW, Rosenberg WM, Chalsani N, Molleston JP. Relationship of Enhanced Liver Fibrosis Score with Pediatric Non-alcoholic Fatty Liver Disease Histology and Response to Vitamin E or Metformin. J Pediatr. 2021 Dec;239:161-167.e5.
- Molleston JP, Bennett WE Jr. Mortality, Risk Factors and Disparities Associated with Esophageal Variceal Bleeding in Children's Hospitals in the United States. J Pediatr. 2021 May;232:176-182.
- Ye W, Narkewicz MR, Leung DH, Karnsakul W, Murray KF, Alonso EM, Magee JC, Schwarzenberg SJ, Weymann A, Molleston JP; CFLDnet research group. Variceal Hemorrhage and Adverse Liver Outcomes in Patients With Cystic Fibrosis Cirrhosis. J Pediatr Gastroenterol Nutr. 2018 Jan;66(1):122-127.
Julio R. Pimenta, MD-MSc
Pediatric Gastroenterology, Hepatology and Nutrition
Hospital das Clínicas da UFMG - Belo Horizonte, Brazil
Hospital Infantil São Camilo Unimed-BH - Belo Horizonte, Brazil
Júlio Pimenta is a physician-scientist with interests in cirrhosis/portal hypertension and pediatric hepatology. The beginning of activities with portal hypertension was through Dr Alexandre Ferreira, and since then he has been focusing his activities in this area. He was introduced to the Baveno Workshops by Dr. Shneider and has continued to play in those meetings with a focus on expanding their impact and relevance to pediatric portal hypertension.
Relevant References- Pimenta JR, Ferreira AR, Fagundes ED, Bittencourt PF, Moura AM, Carvalho SD. Evaluation of endoscopic secondary prophylaxis in children and adolescents with esophageal varices. Arq Gastroenterol. 2017 Jan-Mar;54(1):21-26.
- Pimenta JR, Ferreira AR, Fagundes ED, Queiroz TC, Baptista RA, de Araújo Moreira EG, de Resende CB, Bittencourt PF, Carvalho SD, Neto JA, Penna FJ. Factors associated with bleeding secondary to rupture of esophageal varices in children and adolescents with cirrhosis. J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):e44-e48
- Pimenta JR, Ferreira AR, Bittencourt PF, Resende CB, Fagundes ED, Silva IM. Evaluation of primary prophylaxis with propranolol and elastic band ligation in variceal bleeding in cirrhotic children and adolescents. Arq Gastroenterol. 2016 Oct-Dec;53(4):257-261
- Lopes JRB, Ferreira AR, Liu PMF, Queiroz TCN, Fagundes EDT, Pimenta JR, Neto JAF, Carvalho SD, Borges MEM, Colin LGF. Non-invasive Predictors of Esophageal Varices With a High Risk of Bleeding in Pediatric Cirrhotic Patients. J Pediatr Gastroenterol Nutr. 2021 Jun 1;72(6):802-806
Benjamin L. Shneider, MD
Benjamin Shneider is a physician-scientist with long-standing interests in cholestasis, bile acid homeostasis and cirrhosis/portal hypertension. His interest in pediatric portal hypertension was sparked by early collaboration with Roberto Groszmann at Yale University (1). He was introduced to the Baveno Workshops by Dr. Groszmann and has continued to play an active part in those meetings with a focus on expanding their impact and relevance to pediatric portal hypertension (2,3). Dr. Shneider has leveraged the Baveno knowledge-base and experiences to investigations of pediatric portal hypertension in the context of the NIDDK-funded Childhood Liver Disease Research Network (4,5)
Relevant References- Shneider B and Groszmann R. Portal Hypertension. IN: Liver diseases in children. (F Suchy ed.) Mosby Year Book 1994.
- Shneider B , Bosch J, de Franchis R, Emre S, Groszmann R, Ling S, Lorenz J, Squires R, Superina R, Thompson A, Mazariegos G. Portal hypertension in children: Expert pediatric opinion on the report of the Baveno V consensus workshop on methodology of diagnosis and management of portal hypertension. Pediatr Transpl. 16:426-437, 2012.
- Shneider B , de Ville de Goyet J, Leung D, Srivastava A, Ling S, Duche M, McKiernan P, Superina R, Squires R, Sarin S, de Franchis R, Mazariegos G. Primary prophylaxis of variceal bleeding in children and the role of the mesorex bypass - Summary of the Baveno VI pediatric satellite symposium. Hepatology 63:1368-1380, 2016.
- Shneider BL , Goodrich NP, Ye W, Sawyers C, Molleston JP, Merion RM, Leung DH, Karpen SJ, Kamath BM, Cavallo L, Kasper KS, Teckman JH, Squires JE, Sundaram SS, Rosenthal P, Romero R, Murray KF, Loomes KM, Jensen MK, Bezerra JA, Bass LM, Sokol RJ, Magee JC, for the Childhood Liver Disease Research Network (ChiLDReN). Nonfasted Liver Stiffness Correlates with Liver Disease Parameters and Portal Hypertension in Pediatric Cholestatic Liver Disease. Hepatol. Commun. 4:1694-1707, 2020.
- Bass LM, Ye W, Hawthorne K, Leung DH, Murray KF, Molleston JP, Romero R, Karpen S, Rosenthal P, Loomes KM, Wang KS, Squires RH, Miethke A, Ng VL, Horslen S, Jensen MK, Sokol RJ, Magee J, Shneider BL, on behalf of ChiLDReN. The Risk of Variceal Hemorrhage and Pre-Transplant Mortality in Children with Biliary Atresia. Hepatology. 76:712-726, 2022
Riccardo Superina (Chicago, IL, USA)