Recommendations

Document Overview

Design and created by Guideline Central in participation with the American College of Gastroenterology.

Hereditary Hemochromatosis

American College of Gastroenterology

Publication Date: Aug 1, 2019

Page Last Updated: May 5, 2026

NKF/KDIGO Grading Table

Grade	Strength of Recommendation
Strong “We recommend”	For the Patient	For the Clinician	Policy
Strong “We recommend”	Most individuals in this situation would want the recommended course of action and only a small proportion would not.	Most individuals in this situation would want the recommended course of action and only a small proportion would not. The majority of individuals in this situation would want the suggested course of action, but many would not.	The recommendation can be adopted as policy in most situations.
Conditional (weak) “We suggest”	The majority of individuals in this situation would want the suggested course of action, but many would not.	Different choices will be appropriate for different patients. Decision aids may well be useful in helping individuals making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working toward a decision.	The recommendation is likely to require substantial debate and involvement of stakeholders before policy can be determined.
Expert Opinion		“KDOQI considers it reasonable”

Grade	Quality of Evidence
High	We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate	We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low	Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect.
Very low	We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.
Insufficient	The quality of the evidence was insufficient to make a suggestion or recommendation (to support or not to support the intervention or topic) but important enough to acknowledge as an area for future study.

Document Overview

Document Title: Hereditary Hemochromatosis

Authoring Society: American College of Gastroenterology

Document Publication Date: Aug 1, 2019

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: journals.lww.com/ajg/Fulltext/2019/08000/ACG_Clinical_Guideline__Hereditary_Hemochromatosis.11.aspx

Source Citation: Kowdley, Kris V. MD, FACG; Brown, Kyle E. MD, MSc²; Ahn, Joseph MD, MS, MBA, FACG (GRADE Methodologist); Sundaram, Vinay MD, MSc. ACG Clinical Guideline, The American Journal of Gastroenterology: August 2019 - Volume 114 - Issue 8 - p 1202-1218 doi: 10.14309/ajg.0000000000000315

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Document Objectives: It updates recent advances in the diagnosis, management, and treatment of Hereditary Hemochromatosis

Scope: Assessment and Screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D005820 - Genetic Testing

D006432 - Hemochromatosis

D030342 - Genetic Diseases, Inborn

D005820 - Genetic Testing

D006432 - Hemochromatosis

D030342 - Genetic Diseases, Inborn

Keywords: genetic disorder, genetic testing, hemochromatosis, hereditary, liver biopsy

Target Patient Population: Patients with hereditary hemochromatosis

Inclusion Criteria: Male, Female, Adolescent, Adult, Child, Older Adult

Health Care Settings: Ambulatory, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Number of Source Documents: 174

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: No

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Hereditary Hemochromatosis

Recommendations

Screening for HH

Clinical features

Diagnostic testing

Treatment

Liver transplantation for HH

NKF/KDIGO Grading Table

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology