Budd-Chiari syndrome: consensus guidance of the Asian Pacific Association for the study of the liver (APASL)

Akash Shukla, Ananta Shreshtha, Amar Mukund, Chhagan Bihari, C. E. Eapen, Guohong Han, Hemant Deshmukh, Ian Homer Y. Cua, Cosmas Rinaldi Adithya Lesmana, Mamun Al Meshtab, Masayoshi Kage, Roongruedee Chaiteeraki, Sombat Treeprasertsuk, Suprabhat Giri, Sundeep Punamiya, Valerie Paradis, Xingshun Qi, Yasuhiko Sugawara, Zaigham Abbas, Shiv Kumar Sarin

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42 Citations (Scopus)


Budd Chiari syndrome (BCS) is a diverse disease with regard to the site of obstruction, the predisposing thrombophilic disorders and clinical presentation across the Asia-Pacific region. The hepatic vein ostial stenosis and short segment thrombosis are common in some parts of Asia-Pacific region, while membranous obstruction of the vena cava is common in some and complete thrombosis of hepatic veins in others. Prevalence of myeloproliferative neoplasms and other thrombophilic disorders in BCS varies from region to region and with different sites of obstruction. This heterogeneity also raises several issues and dilemmas in evaluation and approach to management of a patient with BCS. The opportunity to recanalize hepatic vein in patients with hepatic vein ostial stenosis or inferior vena cava stenting or pasty among those membranous obstruction of the vena cava is a unique opportunity in the Asia–Pacific region to restore hepatic outflow closely mimicking physiology. In order to address these issues arising out of the diversity as well as the unique features in the region, the Asia Pacific Association for Study of Liver has formulated these guidelines for clinicians.

Original languageEnglish
Pages (from-to)531-567
Number of pages37
JournalHepatology International
Issue number3
Publication statusPublished - Jun 2021
Externally publishedYes


  • Ascites
  • Budd Chiari syndrome
  • Hepatic vein stenting
  • Hepatocellular carcinoma
  • Liver biopsy
  • Liver transplant
  • MOVC
  • Portal hypertension
  • TIPS


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