Spanish clinical practice guidelines for the diagnosis and management of cholestatic liver diseases in adult and pediatric population: Joint report from AEEH and SEGHNP


Por: Díaz-González Á, Molera C, Gómez-Domínguez E, Muñoz-Bartolo G, Ampuero J, Fernández-Rodríguez C, Quintero J, Molina E, Salcedo M, Olveira A, Morillas R, Díez MA, Casado M, García-Buey L, Rodríguez-Tajes S, Jorquera F, Berenguer M, Montero JL and Londoño MC

Publicada: 1 abr 2026 Ahead of Print: 1 abr 2026
Resumen:
Cholestatic liver diseases comprise a heterogeneous group of disorders affecting both adult and pediatric population, characterized by alterations in bile formation, secretion, or flow, leading to the accumulation of bile acids and other toxic substances in the liver. In recent years, advances in new pharmacological therapies, the availability of next-generation genetic sequencing techniques, and the development of specific treatments for genetic cholestasis have transformed the diagnostic and therapeutic approach to these conditions. This document, jointly prepared by the "Asociaci & oacute;n Espanola para el Estudio del Higado" (AEEH) and the "Sociedad Espanola de Gastroenterologia, Hepatologia y Nutrici & oacute;n Pedi & aacute;trica" (SEGHNP), presents a national evidence-based guideline for the diagnosis and management of hepatic cholestasis in Spain. It addresses recommendations for differential diagnosis, diagnostic algorithms, indications for genetic studies, treatment and follow-up criteria in diseases such as primary biliary cholangitis, primary sclerosing cholangitis, genetic cholestasis, intrahepatic cholestasis of pregnancy, and vanishing bile duct syndrome. In addition, recommendations are included for the management of extrahepatic complications, indications for liver transplantation, and special considerations in pregnancy and childhood. The guideline emphasizes the importance of a multidisciplinary approach, the use of non-invasive tools for risk stratification, and the incorporation of new targeted therapies, with the aim of improving the prognosis and quality of life of patients affected by cholestatic liver diseases. (c) 2025 The Author(s). Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Filiaciones:
Díaz-González Á:
 Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases Group, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain

Molera C:
 Pediatric Gastroenterology, Hepatology and Nutrition Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain

Gómez-Domínguez E:
 Digestive Diseases Department, Hospital Universitario 12 de Octubre, Madrid, Spain

Muñoz-Bartolo G:
 Department of Paediatric Hepatology, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), La Paz Children's University Hospital, Madrid, Spain

Ampuero J:
 Digestive Diseases Department, Hospital Universitario Virgen del Rocío, Sevilla, Spain

 Instituto de Biomedicina de Sevilla, Spain

 CIBEREHD, Madrid, Spain

 Universidad de Sevilla, Sevilla, Spain

Fernández-Rodríguez C:
 Digestive Diseases Department, Hospital Universitario Fundación Alcorcón, University Rey Juan Carlos, Madrid, Spain

Quintero J:
 Pediatric Hepatology and Liver Transplant Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain

Molina E:
 Digestive Diseases Department, Complexo Hospitalario Universitario de Santiago, Santiago, Spain

Salcedo M:
 Digestive Diseases Department. Hospital General Universitario Gregorio Marañón, Madrid, Spain

Olveira A:
 Gastroenterology Department, Hospital Universitario La Paz, Madrid, Spain

Morillas R:
 Hepatology Unit, Hospital Universitari Germans Trias i Pujol, Centro de investigación biomédica en red Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain

Díez MA:
 Department of Paediatric Hepatology, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), La Paz Children's University Hospital, Madrid, Spain

Casado M:
 Gastroenterology department Torrecárdenas Hospital, Almeria, Spain

García-Buey L:
 Digestive Diseases Department, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Madrid, Spain

Rodríguez-Tajes S:
 Liver Unit, Hospital Clínic Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Universitat de Barcelona, Centro de investigación biomédica en red Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain

Jorquera F:
 Gastroenterology and Hepatology, Complejo Asistencial Universitario de León, Spain

Berenguer M:
 Liver Transplantation and Hepatology Unit, Hospital Universitari i Politècnic La Fe, IISLaFe, Universidad de Valencia, Centro de investigación biomédica en red Enfermedades Hepáticas y Digestivas (CIBEREHD), Valencia, Spain

Montero JL:
 UGC Ap. Digestivo. Unidad de Hepatología y Trasplante Hepático. Hospital Universitario Reina Sofía, Córdoba, Spain

Londoño MC:
 Liver Unit, Hospital Clínic Barcelona, Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Universitat de Barcelona, Centro de investigación biomédica en red Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
ISSN: 02105705





Gastroenterologia y Hepatologia
Editorial
ELSEVIER ESPANA SLU, Carrer de Tarragona, 161  15th floor, BARCELONA 08014, SPAIN, España
Tipo de documento: Article
Volumen: 49 Número: 4
Páginas: 502629-502629
WOS Id: 001737449600001
ID de PubMed: 41232665
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