Panda K, Dash DP, Pati GK, Maria A, Gautam V. Diagnostic accuracy of blood-based non-invasive tests for prediction of varices in pediatric portal-hypertension: A systematic review and meta-analysis. World J Hepatol 2026; 18(4): 118038 [DOI: 10.4254/wjh.v18.i4.118038]
Corresponding Author of This Article
Kalpana Panda, DM, MD, Associate Professor, Department Pediatric Gastroenterology and Hepatology, Institute of Medical Sciences and SUM Hospital, Kalinga Nagar, Bhubaneshwar 751003, Odisha, India. drkalpanapanda@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
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Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Apr 27, 2026 (publication date) through Apr 22, 2026
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Publication Name
World Journal of Hepatology
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1948-5182
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Panda K, Dash DP, Pati GK, Maria A, Gautam V. Diagnostic accuracy of blood-based non-invasive tests for prediction of varices in pediatric portal-hypertension: A systematic review and meta-analysis. World J Hepatol 2026; 18(4): 118038 [DOI: 10.4254/wjh.v18.i4.118038]
World J Hepatol. Apr 27, 2026; 18(4): 118038 Published online Apr 27, 2026. doi: 10.4254/wjh.v18.i4.118038
Diagnostic accuracy of blood-based non-invasive tests for prediction of varices in pediatric portal-hypertension: A systematic review and meta-analysis
Kalpana Panda, Devi P Dash, Girish K Pati, Arjun Maria, Vipul Gautam
Kalpana Panda, Department Pediatric Gastroenterology and Hepatology, Institute of Medical Sciences and SUM Hospital, Bhubaneshwar 751003, Odisha, India
Devi P Dash, Department of Critical Care Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar 751024, Odisha, India
Girish K Pati, Department of Gastroenterology and Hepatology, Institute of Medical Sciences and SUM Hospital, Bhubaneshwar 751003, Odisha, India
Arjun Maria, Department of Pediatric Gastroenterology and Hepatology, Amrita School of Medicine, Amrita Hospital, Faridabad 121002, Haryana, India
Vipul Gautam, Department of Pediatric Hepatology and Liver Transplant, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, New Delhi 110017, Delhi, India
Author contributions: Panda K, Dash DP, and Pati GK conceptualized the meta-analysis and developed the study protocol; Panda K, Dash DP, Pati GK, Maria A and Gautam V performed the literature search, study selection, data extraction, and quality assessment; Panda K and Pati GK drafted the manuscript; Dash DP, Maria A and Gautam V provided the necessary intellectual inputs; all authors have critically revised and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Kalpana Panda, DM, MD, Associate Professor, Department Pediatric Gastroenterology and Hepatology, Institute of Medical Sciences and SUM Hospital, Kalinga Nagar, Bhubaneshwar 751003, Odisha, India. drkalpanapanda@gmail.com
Received: December 25, 2025 Revised: January 8, 2026 Accepted: February 5, 2026 Published online: April 27, 2026 Processing time: 120 Days and 15.3 Hours
Core Tip
Core Tip: Blood-based non-invasive tests offer a pragmatic approach for risk stratification of varices in children with portal hypertension. This meta-analysis reveals that commonly used indices, such as aminotransferase-to-platelet ratio index, platelet count, demonstrate moderate diagnostic accuracy and may help identify children at lower risk who could safely defer immediate endoscopic surveillance. Their advantages include wide availability, low cost, and ease of repeat testing, making them particularly relevant in resource-limited settings. However, substantial heterogeneity, variability in applied cut-off thresholds, and low-to-moderate certainty of evidence limit their reliability as standalone tools. Prospective pediatric studies with standardised and aetiology-specific cut-offs are essential before implementing routine guidelines.
