Adam Testro

@DfarmerDouglas @CarolynSmullin @UCLAHealth @UCLASurgery @UCLASurgeryRes Amazing. Well done.

Happy to share our publication on the first use of Paragonix LIVERguard(r) for the safe transport and transplant of a multivisceral graft. Congratulations @CarolynSmullin @UCLAHealth @UCLASurgery @UCLASurgeryRes authors.elsevier.com/sd/article/S29…

Pleased to share the 2025 @Austin_Health Liver and Intestinal Transplant Medicine Research Report. It was another very productive year for our small team of busy clinicians.

🚨Low ticket alert 🚨 We are only 4 weeks out from the @Austin_Health ACTER Advanced Liver Disease Symposium - Critical Care Hepatology. A must for clinicians in the gastroenterology and critical care/ICU space. Avoid disappointment and book now 👇 trybooking.com/events/landing…

Meet the speakers #4: Dr Caleb Fisher BA, BSc, MBBS, FCICM, FRACP Department of Intensive Care, Austin Health. Department of Critical Care, The University of Melbourne.

An excellent review from our @Austin_Health team 👇

Meet the speakers #3: Dr Anoop Koshy is an Interventional Cardiologist based at Austin Health.

Meet the speakers #2: Professor James O’Beirne MBBS (Hons) MD FRACP FRCP EDIC Prof. O’Beirne is a Consultant Hepatologist at the Sunshine Coast University Hospital, Queensland.

Professor Bernal will join us in Melbourne in February to present on “Acute Liver Failure” and “Acute on Chronic Liver Failure”. Register now before it’s too late. lnkd.in/eqBYPwfU

Meet our 2026 International Keynote speaker. William Bernal is Professor of Liver Critical Care Medicine at Kings College Hospital, London, serving one of the largest liver transplant programs in Europe.

👏 Amazing new publication from @mariej_sinclair et al @Austin_Health @UniMelb 🥳 . The authors prospectively assessed the impact of 12 weeks of home continuous terlipressin infusion in decompensated cirrhosis 🏠 💉🧑‍⚕️ . Novel findings of ⬇️ renin, ⬇️ aldosterone and ⬆️ ACE2 🤔 Should we be using terli for longer? Should we be using it to prevent HRS? 💭 t.co/ZTIY1aS6Cf @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @pancreatitis_nl @SEEDendoscopia @EASLedu @AmCollegeGastro @Aegastro @SAGES_updates @UHSEndoscopy @WAGE_media #BSGLIVE25 #GITwitter #livertwitter #gastroenterology #MedEd #Renal

Sat Feb 28, 2026 lnkd.in/eqBYPwfU

Featuring international keynote speaker Professor Will Bernal from King’s College Hospital, UK and local keynote speaker Professor James O’Beirne from Sunshine Coast University Hospital.

Want a practice update in critical care hepatology? Bookings are now open for the @Austin_Health 2026 ACTER Advanced Liver Disease Symposium. The 2026 symposium will have broad appeal for health care providers in both gastroenterology and intensive care medicine.

Terlipressin is to the portal circulation what norepinephrine is to the systemic one — precise, powerful, and now, with continuous infusion, safer and smarter than ever. Terlipressin – Old Molecule, New Directions in Cirrhosis Care (Based on Hepatology Communications, April 2025) 🧬 Essence Terlipressin is a potent vasopressin analog that selectively constricts the splanchnic circulation, reducing portal inflow and pressure. It is well-established for portal hypertensive bleeding (PHB) and hepatorenal syndrome–acute kidney injury (HRS-AKI). The modern shift toward continuous terlipressin infusion (CTI) has demonstrated superior hemodynamic stability and a lower risk of ischemic side effects compared to traditional bolus dosing. ⚙️ Mechanism and Hemodynamics Terlipressin produces a more sustained fall in hepatic venous pressure gradient (HVPG), a rise in mean arterial pressure (MAP), and a reduction in heart rate, compared to octreotide. In contrast, octreotide’s initial HVPG reduction rebounds within minutes, likely due to rapid desensitization of somatostatin receptors. Hence, terlipressin maintains prolonged portal pressure control, a key factor in preventing variceal rebleeding and improving systemic perfusion. 🩺 Clinical Roles Terlipressin remains the cornerstone in acute variceal bleeding and HRS-AKI. However, emerging evidence supports its use in refractory ascites, hepatic hydrothorax, and as a bridging therapy for liver transplant candidates requiring long-term circulatory support to control HRS recurrence and fluid overload. Continuous ambulatory terlipressin infusions are now being explored as part of home-based management programs for decompensated cirrhosis. ⚖️ Terlipressin versus Octreotide Octreotide, a somatostatin analog, causes transient splanchnic vasoconstriction by inhibiting vasodilators, but its hemodynamic impact is less durable. Terlipressin, through direct vasopressin receptor stimulation, achieves a greater and longer-lasting reduction in portal pressure and better systemic circulatory support. Randomized trials involving over 700 patients have shown comparable control of bleeding and mortality between terlipressin, octreotide, and somatostatin when used alongside endoscopic band ligation. However, terlipressin provides stronger immediate control of active bleeding at endoscopy. Importantly, no study has yet compared continuous terlipressin infusion (CTI) with octreotide for acute variceal bleeding, although CTI is expected to outperform bolus therapy due to steady portal pressure reduction. ⚕️ Safety and Monitoring Terlipressin can cause hyponatremia, abdominal pain, and ischemic complications in the heart, bowel, or extremities. Continuous infusion minimizes these peaks and troughs in vasoconstrictive effect, thereby reducing ischemic risks. Close monitoring of serum sodium, urine output, mean arterial pressure, and ischemic symptoms is essential during therapy. 💡 CME INDIA Take-Home Terlipressin remains the most potent and physiologically rational vasoactive drug in portal hypertension. Continuous infusion provides stable hemodynamics and improved safety compared to bolus dosing. Evidence is expanding for its role in refractory ascites and bridging to transplant. Future trials must compare CTI directly with octreotide to confirm superiority in acute variceal bleeding. In experienced hands, terlipressin is transforming from a rescue agent to a strategic long-term therapy in decompensated cirrhosis. 🧠 CME INDIA Insight: Terlipressin is to the portal circulation what norepinephrine is to the systemic one — precise, powerful, and now, with continuous infusion, safer and smarter than ever. journals.lww.com/hepcomm/fullte…

📑 The current applications and future directions of #terlipressin‼️ journals.lww.com/hepcomm/fullte…

More excellent work produced by Angus Jeffrey who has been with us the past year 👇 cghjournal.org/article/S1542-… @JHepatolog @AvikMajumd

The Portal Hypertension Decompensation Score 👇journals.lww.com/ajg/abstract/9… @AmJGastro @AvikMajumd