Portal hypertension is a complex, heterogeneous condition. Its presentation, mechanisms, and clinical consequences vary widely across age groups, etiologies, and individual patient characteristics. Traditional, uniform approaches to risk stratification and management are increasingly insufficient to address this complexity, particularly as new diagnostic tools, genetic insights, and therapeutic strategies emerge.

This 2-part symposium—jointly planned by the Pediatric Liver Disorder and the Portal Hypertension Special Interest Groups—explores personalized approaches to portal hypertension across the lifespan, from childhood to adulthood, integrating pediatric and adult perspectives. Through case-based discussions and expert-led presentations, the sessions address contemporary strategies for risk stratification, management of portal vein thrombosis, and acute and long-term complications of portal hypertension.

Portal hypertension is a complex, heterogeneous condition. Its presentation, mechanisms, and clinical consequences vary widely across age groups, etiologies, and individual patient characteristics. Traditional, uniform approaches to risk stratification and management are increasingly insufficient to address this complexity, particularly as new diagnostic tools, genetic insights, and therapeutic strategies emerge.

This 2-part symposium—jointly planned by the Pediatric Liver Disorder and the Portal Hypertension Special Interest Groups—explores personalized approaches to portal hypertension across the lifespan, from childhood to adulthood, integrating pediatric and adult perspectives. Through case-based discussions and expert-led presentations, the sessions address contemporary strategies for risk stratification, management of portal vein thrombosis, and acute and long-term complications of portal hypertension. Presenters particularly emphasize tailoring decisions based on disease mechanisms, patient-specific factors, and evolving evidence, with the goal of improving outcomes and optimizing care pathways in both pediatric and adult populations.

Jointly presented by the American Association for the Study of Liver Diseases and the Japan Society of Hepatology, this progam is the second of 2 sessions with the shared goal of reviewing evolving strategies in liver cancer management in Eastern and Western regions. The first session, presented at Japan DDW 2026 in Kobe, Japan, focused on liver cancer treatment. This second session focuses on the prevention of liver cancer in persons with viral and metabolic liver diseases.

Chronic hepatitis B virus (HBV) infection affects 250 mllion persons worldwide at all ages of life. It can be a heterogeneous disease with variable manifestations in children, immunocompromised persons, those with hepatitis D virus (HDV) coinfection, and older adults. This Hepatitis B/Delta Special Interest Group session highlights the management of chronic hepatitis B infection in various special populations across the age spectrum, starting from prevention of mother-to-child transmission (MTCT) of HBV through to older adults with HBV–related cirrhosis and hepatocellular carcinoma. This session hosts a roster of international experts who highlight recent advances in the following topics: 

• Universal HBV vaccination and prevention of MTCT of HBV
• Horizontal transmission of HBV in the pediatric population 
• Prevention of HBV reactivation 
• HBV/HDV coinfection
• HBV infection in older adults 

The current definition of recompensation, established at the Baveno consensus several years ago, was largely based on expert opinion at a time when robust longitudinal data were limited. Since then, accumulating clinical evidence has begun to redefine the concept of recompensation, suggesting that a broader and more heterogeneous group of patients may experience meaningful and sustained improvement. However, major questions remain unresolved, including whether recompensation can be recognized in patients requiring low-dose diuretics, in those treated with a transjugular intrahepatic portosystemic shunt (TIPS), and whether it should be restricted to etiologies that can be cured or instead defined by sustained clinical and functional improvement. In addition, it remains unclear whether the concept of recompensation can be applied to pediatric populations, where data are particularly scarce.

The session speakers explore these evolving definitions, review emerging evidence and openly discussing ongoing controversies, including whether current practice should continue to rely on the Baveno definition or move toward updated, data-driven frameworks, with the goal of clarifying how recompensation should be understood and applied in contemporary clinical practice.

​​​​​Explore timely topics in liver disease in a lively debate format as hepatology trainees and practicing hepatologists tackle important often controversial issues. Debaters gain skills in critical thinking, balanced argumentation, and factual examination of each issue’s pros and cons. Debaters, judges, and audience members grapple with opposing scientific, societal, individual, and financial viewpoints on current clinical concerns. This session highlights teams of 2 fellows supported by faculty mentors who present arguments in support of or against a question theme. This year's debate question is: "Is Resmetirom or Semaglutide the Best First-Line Treatment for Metabolic Dysfunction–Associated Steatohepatitis With Stage 2–3 Fibrosis for a Specific Clinical Vignette?" 

MASH is a common clinical condition that, if untreated, can lead to the development of cirrhosis and liver decompensation. Currently, there are only 2 US Food and Drug Administration–approved medications for MASH with stage 2–3 fibrosis that have the potential for MASH resolution and fibrosis regression: resmetirom and semaglutide. Which medication is the best first-line therapy is unclear. One debate team argues resmetirom is the best first-line choice; the other argues that semaglutide is the best first-line choice.

Take advange of the opportunity to learn from past women presidents of the American Association for the Study of Liver Diseases (AASLD) in this engaging and insightful discussion. Panelists reflect on their individual pathways to leadership, discuss challenges and successes they encountered throughout their careers, and offer guidance for aspiring future leaders. Following a brief introduction providing an overview of pathways to leadership within AASLD, the remainder of the session is conducted in a panel discussion format.

The diagnosis of hepatic vascular disorders raises several challenges for clinicians, radiologists, and pathologists. These disorders include sinusoidal/postsinusoidal etiologies like sinusoidal obstruction syndrome (SOS), Budd-Chiari syndrome, and cardiac/pericardial disease. Diagnosis of these conditions as well as the interpretation of fibrosis and nodular lesions in this setting can be challenging. The terminology and diagnostic criteria for portal vein and presinusoidal etiologies are also not well defined and have been grouped under a variety of terms like noncirrhotic portal fibrosis, idiopathic portal hypertension, and obliterative portal venopathy.

The term porto-sinusoidal vascular disorder (PSVD) has been recently proposed. A multisociety initiative to review and standardize the nomenclature was jointly managed by the American Association for the Study of Liver Diseases, the European Association for the Study of the Liver, the Latin American Society for Study of Liver, and Asian Pacific Association for the Study of the Liver, with support and input from global pathology societies and the United States and Canadian Academy of Pathology. Both PSVD and noncirrhotic portal hypertension (NCPF) were considered acceptable terms based on the discussions. The clinical, radiologic, and pathologic criteria for diagnosis of PSVD were discussed and are currently being finalized. This session includes cases that illustrate diagnostic challenges and other clinically relevant aspects of hepatic vascular disorders with a focus on criteria and the appropriate use of the term PSVD.

Persons living with chronic liver disease are burdened by symptoms that negatively impact their quality of life, complications that result in frequent hospitalizations, and medications that require close monitoring and frequent titration. The holy grail of optimal hepatology care is a close patient-clinician relationship with easy access and efficient methods for medication adjustment and symptom monitoring. Digital tools, including virtual care, remote monitoring platforms, wearables, and now artificial intelligence (AI)–based technologies have the promise to bring this ideal vision closer to realization. At the same time, as we incorporate new technology into care delivery, we must consider the perspectives of key stakeholders to optimize workflows and mitigate any unintended consequences.

Presented as a partnership between the Clinical Informatics and Digital Health Special Interest Group and the Public Health/Health Care Delivery Special Interest Group, this program brings together patients and health care practitioners to share perspectives on the potential benefits, concerns, and important considerations on how to best incorporate digital tools and AI into clinical care. The session utilizes a case-based approach to explore the promise and pitfalls of using digital technology and AI in the following areas: clinical administrative tasks (eg, writing clinical notes, creating after-visit summaries); patient-facing tasks such as responding to patient portal messages; and promotion of patient education and health literacy. Each scenario begins with a brief vignette centered around one of the aforementioned areas; attendees will hear the perspectives of both patients and practitioners on the topic. The session concludes with a discussion with the speaker panel and audience questions and answers.

Electronic health record (EHR)–based, real-world data are increasingly used in clinical research for hepatology and liver transplantation. Analysis of these data have the potential to shape quality improvement, clinical trials, and regulatory decision-making. Large-scale, EHR–based datasets—such as Epic Cosmos, TriNetX, OMOP–based networks, All of Us, PCORnet, Mayo Clinic Platform Connect, Target RWE, AASLD’s Cirrhosis Quality Collaborative (CQC), and the Veterans Affairs' CIPHER, LEAP, and MVP—offer unprecedented opportunities to study liver disease at scale but differ substantially in structure, governance, analytic flexibility, and validity for specific research questions.

This community conversation—presented as a partnership between the Clinical Informatics and Digital Health Special Interest Group and the Clinical Research Committee—provides a practical framework for understanding EHR–based, real-world data, with an emphasis on applications in chronic liver disease and liver transplantation. Three focused presentations review the strengths and limitations of EHR–derived datasets, highlight Epic Cosmos as one of the largest available platforms, and explore Target RWE’s collaboration with AASLD through the CQC. The session concludes with an interactive panel discussion addressing methodological challenges, real-world use cases, and future directions for hepatology research and quality improvement.