Baveno VIII Consensus Conference provides updated guidance on advanced chronic liver disease, portal hypertension and vascular liver disease

Extensively updated set of clinical recommendations published in the Journal of Hepatology

Baveno, 25 August 2026 – The guidance comes from the Baveno VIII Consensus Conference, the latest in a series of expert meetings that has shaped portal hypertension and advanced chronic liver disease (ACLD) care for more than three decades. Developed by an international faculty of experts, the recommendations aim to improve the diagnosis, prevention, and treatment of complications of portal hypertension across the entire spectrum of ACLD and vascular liver disease.

A tradition of shaping the field

Convened every five years since 1990 by the Baveno Cooperation and, more recently, the Vascular Liver Disease Interest Group (VALDIG), these conferences have steadily shifted the field from the mere treatment of complications, such as variceal bleeding, to prevention of all types of complication (i.e. decompensation). This year’s meeting, returning to an in-person format following the virtual COVID-19 conference, brought together 84 faculty members from around the world across nine expert panels.

What’s new

In total, the conference produced 272 statements and recommendations that reached strong consensus (defined as agreement by more than 80% of the expert faculty), along with a research agenda comprising 153 priority topics to guide future studies. Highlights include:

• Non-invasive tests (NITs): Updated guidance on blood- and imaging-based tests, which continue to take centre stage in identifying patients with compensated ACLD and clinically significant portal hypertension (CSPH), with several diagnostic thresholds refined in light of new evidence.
• Predicting decompensation directly: Rather than focusing solely on estimating the probability of CSPH, the field is shifting towards non-invasively identifying patients most likely to develop their first major complication and monitoring them serially so that screening and pharmacological preventive therapies can be initiated earlier and more effectively.
• Updated management of variceal bleeding, ascites and other complications: Refined recommendations cover resuscitation, blood transfusion thresholds, antibiotic use, endoscopic and pharmacological treatment, and criteria for placement of transjugular intrahepatic portosystemic shunts (TIPS) in patients with severe or recurrent complications. It also includes recommendations on nutritional assessment and management in patients with ACLD.
• New guidance on “recompensation”: The conference formally refined the criteria by which patients with decompensated cirrhosis who received etiologic treatment of their underlying liver disease can be considered to have returned to a compensated stage with a considerably improved prognosis.
• Expanded coverage of vascular liver diseases: Led by VALDIG, Baveno VIII provides new guidance on the diagnosis and management of Budd–Chiari syndrome, portosinusoidal vascular disorder (PSVD; also known as non-cirrhotic portal fibrosis [NCPF] in some regions), and portal vein thrombosis, including guidance on anticoagulation, pregnancy, and endovascular interventions.
• First-ever paediatric guidance: Reflecting the involvement of paediatric hepatologists for the first time, the conference issued recommendations addressing portal hypertension and vascular liver disease specifically in children.

Why it matters

Advanced chronic liver disease (a term that was shaped by the Baveno Cooperation and should be preferred over the traditional term “cirrhosis”) and portal hypertension remain leading causes of morbidity and mortality worldwide, with clinical decisions often hinging on identifying patients at meaningfully elevated risk of life-threatening complications, such as variceal bleeding, ascites, and hepatic encephalopathy. By refining non-invasive risk stratification and clarifying when preventive treatments should be started, adjusted, or stopped, the Baveno VIII recommendations are intended to help clinicians intervene earlier and more precisely – potentially reducing avoidable hospitalizations and deaths, while avoiding unnecessary procedures in lower risk patients.

Looking ahead

Alongside its clinical recommendations, the conference identified 153 open research questions spanning all nine panel areas – from validating artificial intelligence-based diagnostic tools to determining optimal anticoagulation strategies in vascular liver disease and urgently needed research in paediatric liver disease – signalling where the field expects the next major advances to come from ahead of the Baveno IX conference.

For more than 30 years, Baveno has helped shape the evolution of portal hypertension care. Baveno VIII continues that tradition – not only by updating what we know today, but by identifying the research priorities that will define where the field goes next.

The article is available at: https://doi.org/10.1016/j.jhep.2026.07.030

About EASL

EASL, the European Association for the Study of the Liver, is a medical association serving over 7,700 members worldwide. EASL is committed to fostering liver disease awareness, prevention and the best possible patient care.

About Baveno

The Baveno Cooperation is an official EASL consortium with a mission to set standards for the clinical management of patients with advanced chronic liver disease (ACLD), with a particular focus on complications of portal hypertension.

About VALDIG

VALDIG (Vascular Liver Disease Group) is an independent network of researchers with a common interest in Vascular Liver Diseases. The aim of this network is to foster research in this field. All VALDIG centres are connected by one database, which allows for the coordination of joint research projects.

For further information

Thomas Reiberger (Baveno-Secretary)

E-mail address: thomas.reiberger@meduniwien.ac.at