High pressure in portal vein is most often caused by cirrhosis of the liver, scarring leading to increased resistance within the veins.

Portal hypertension is elevated pressure in your portal venous system. The portal vein is a major vein that leads to the liver. The most common cause of portal hypertension is cirrhosis (scarring) of the liver. What is the best treatment for portal hypertension? Liver transplantation is the only effective treatment for cirrhosis and portal hypertension. Liver transplantation means your diseased liver is replaced with a healthy one from deceased donors or living donors who donate portions of the liver.