The International Club of Ascites (ICA) is a non-profit scientific organization dedicated to advancing knowledge and improving the management of ascites and its associated complications. Since its foundation in 1990, The ICA has pursued the objective of harmonizing definitions and diagnostic criteria related to ascites and its complications, while actively promoting high-quality research in the field. Over the years, its scope has expanded to other conditions associated with decompensated cirrhosis, including renal dysfunction, infections, and other systemic complications.
Salvatore Piano is Associate Professor of Medicine and Consultant Hepatologist at the University and Hospital of Padova, Italy. His main research interests are pathophysiology and treatment of complications of cirrhosis: ascites, acute kidney injury, hepatorenal syndrome, bacterial infections and acute-on-chronic liver failure. He conducted several clinical studies and randomized controlled clinical trials on complications of cirrhosis. His research has been supported by European Commission, Italian Ministry of Health, Italian Ministry of University and Research and EASL.
Rakhi Maiwall is Professor of Hepatology and Head of the liver intensive care unit at Institute of Liver and Biliary Sciences, New Delhi, India. She has special interest in critical care hepatology, renal dysfunction in patients with cirrhosis, liver failure and artificial liver support therapies. She has published 200 articles in indexed journals and contributed 12 book chapters.
Sumeet Asrani, MD, MSc is the Chief of Hepatology and Liver Transplantation at the Baylor Simmons Transplant Institute in Dallas and Fort Worth. He is also the director of Hepatology research and helps lead the research efforts for the abdominal transplant institute. Dr. Asrani has published 225 peer review publications, 300 abstracts and given over 125 national and international presentations. In addition, he has mentored more than 35 trainees to help advance their medical careers. Dr. Asrani previously served as an associate editor for the American Journal of Transplantation (AJT) and as an associate editor for Liver Transplantation (LT). He is actively involved in national and international collaborations to improve care for patients with liver disease. In his free time, Dr, Asrani enjoys various fitness endeavors, playing the drums, and traveling with his wife and four children.
Andrew S. Allegretti, MD, MSc, is an Associate Professor of Medicine at Harvard Medical School and is the Director of Critical Care Nephrology at Massachusetts General Hospital. He is a Principal Investigator in the MGH Kidney Research Center and the chair/founder of the HRS-HARMONY research collaborative. Dr. Allegretti’s research interests include mechanisms of injury in hepatorenal syndrome, outcomes around acute kidney injury in the critical care setting, and the clinical trials of novel therapeutics in chronic kidney disease. He has served as lead PI and/or steering committee member on multiple national randomized clinical trials. His work has been supported by awards from the NIH, American Heart Association, American Association for the Study of Liver Diseases, and the American College of Gastroenterology.
Claire Francoz, MD, PhD) is Assistant Professor in the department of Hepatology at the University of Paris VII (Hôpital Beaujon), Clichy, France. She is currently responsible of the Liver Intensive Care Unit and Transplant program in the same department. Her main research interests focus on acute liver failure and decompensated cirrhosis, particularly renal failure. She has published more than 180 papers in international peer review journals. She has served as vice-chair of the EDI committee of ILTS and is currently member of the scientific committee of the UEG. She is also associate editor of Transplantation and serves on the editorial board of the Journal of Hepatology.
Adrià Juanola is a hepatologist and clinical-translational researcher at Hospital Clínic de Barcelona and IDIBAPS, Barcelona, Spain. His research focuses on chronic liver disease, decompensated cirrhosis, and its major complications, including acute kidney injury, immune dysfunction, bacterial infections, and acute-on-chronic liver failure. He is particularly interested in prognostic biomarkers, risk stratification, and the development of early diagnosis and population-based screening strategies for liver disease.
Dr. Sebastián Marciano is a specialist in Internal Medicine and Hepatology, with a Master’s degree in Clinical Research and a PhD in Health Sciences. He serves as Head of Hepatology at Hospital Italiano de Buenos Aires, leads the Clinical Research Area at the University of Hospital Italiano de Buenos Aires, is an Independent Researcher at CONICET, and coordinates the Research Department of the Latin American Association for the Study of the Liver (ALEH). His main research interests include viral hepatitis, liver transplantation, and complications of cirrhosis, particularly bacterial infections.
The International Club of Ascites (ICA) was founded in Florence, Italy, on November 30, 1990, during an international liver meeting, with the aim of advancing knowledge and improving the management of ascites and its complications.
The original name of the Club was “International Ascites Club”.Since November 2005 the name of the club has been changed to: International Club of Ascites (ICA).
Since its establishment, the Club has played a pivotal role in providing guide on definitions and management of complications of cirrhosis. During its first two decades, the ICA organized several international meetings, each focused on key clinical challenges in the field.
These meetings brought together leading experts and fostered scientific discussion that led to the publication of nine consensus papers in high-impact journals. These consensus documents have been instrumental in standardizing definitions, diagnostic criteria, and therapeutic approaches in hepatology.
Among its most influential contributions are the development and refinement of definitions for refractory ascites, hepatorenal syndrome, renal dysfunction in cirrhosis, spontaneous bacterial peritonitis, sepsis, and hyponatremia.
Consensus papers include those on refractory ascites and hepatorenal syndrome (1996), spontaneous bacterial peritonitis (2000), ascites management (2003), sepsis in cirrhosis (2005), hepatorenal syndrome (2007), and the classification of renal dysfunction (2011).
Subsequent reports further addressed emerging challenges and updated clinical perspectives, including limitations in the management of renal dysfunction (2013) and revised criteria and recommendations for acute kidney injury in cirrhosis (2015 and 2024).
In more recent years, the ICA has expanded its role beyond consensus building to lead and support international research projects.
This includes global, prospective, multicenter studies investigating the epidemiology and impact of bacterial infections (2016-20189 and acute kidney injury in patients with cirrhosis (2022-2025).
The ICA is led by a Secretary (currently Salvatore Piano, Italy) and a Vice-Secretary/Treasurer (currently Rakhi Maiwall, India), supported by a Scientific Committee composed of seven members representing different regions of the world.
The Committee includes three members from Europe (currently Claire Francoz, France; Adrià Juanola, Spain; Salvatore Piano, Italy), three from the Americas (currently Sumeet Asrani, USA; Andrew Allegretti, USA; Sebastian Marciano, Argentina), and one from Asia (currently Rakhi Maiwall, India).
In accordance with the Club’s statutes, the Scientific Committee ensures representation of expertise in renal function, reflecting the central role of kidney involvement in advanced liver disease.
The organizational location of the club is the secretary’s office (currently Department of Medicine, University of Padova, Via Giustiniani 2, Padova, Italy).
"ICA consensus on acute kidney injury in patients with cirrhosis - Venice 2012"
Explore where members of the International Club of Ascites are located worldwide.
A growing international community.
1. G. Laffi (secretary, Italy), L. Blendis (Canada), F. Dudley (Australia), A. Gerbes (Germany), H. Ring- Larsen (Denmark), E. Zambranski (US).
2. P. Gines (secretary, Spain), K. Moore (UK), R. Moreau (France), M. Pinzani (Italy), B.A. Runyon (US), F. Wong (Canada).
3. K. Moore (secretary, UK), G. Garcia-Tsao (US), R. Moreau (France), M. Pinzani (Italy), R. Planas (Spain), F. Wong (Canada).
4. F. Wong (secretary, Canada), G. Garcia-Tsao (US), R. Moreau (France), D. Patch (UK), R. Planas (Spain), F. Salerno (Italy).
5. F. Salerno (secretary, Italy), B. Bernard (France), G. Garcia-Tsao (US), M. Guevara (Spain), S. Lee (Canada), R. Terg (Argentina).
6. S. Lee (secretary, Canada), P. Angeli (Italy), A. Sanyal (US), M. Guevara (Spain), S. Moller (Denmark), R. Terg (Argentina).
7. P. Angeli (secretary, Italy), A. Sanyal (US), R. Kim (US), C. Alessandria (Italy), A. Krag (Denmark), A. Gadano (Argentina), S. Sarin (India).
8. P. Angeli (secretary, Italy), S. Sarin (India), A. Sanyal (US), R. Kim (US), F. Durand (Italy), A. Krag (Denmark), A. Gadano (Argentina).
9. F. Durand (secretary, France), R. Maiwall (India), S. Piano (Italy), S. Asrani (US), M. Nadim (US), S. Marciano (Argentina), V. Singh (India).
