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Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension: Korean multicenter real-practice data

Title
Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension: Korean multicenter real-practice data
Author
전대원
Keywords
Liver cirrhosis; Transjugular intrahepatic portosystemic shunt; Portal hypertension
Issue Date
2014-04
Publisher
Korean Association for the Study of the Liver
Citation
Clinical and Molecular Hepatology, 2014, 20(1). P.18-27
Abstract
Background/Aims: This retrospective study assessed the clinical outcome of a transjugular intrahepaticportosystemic shunt (TIPS) procedure for managing portal hypertension in Koreans with liver cirrhosis. Methods: Between January 2003 and July 2013, 230 patients received a TIPS in 13 university-based hospitals. Results: Of the 229 (99.6%) patients who successfully underwent TIPS placement, 142 received a TIPS for varicealbleeding, 84 for refractory ascites, and 3 for other indications. The follow-up period was 24.9±30.2 months (mean±SD),74.7% of the stents were covered, and the primary patency rate at the 1-year follow-up was 78.7%. Hemorrhageoccurred in 30 (21.1%) patients during follow-up; of these, 28 (93.3%) cases of rebleeding were associated with stentdysfunction. Fifty-four (23.6%) patients developed new hepatic encephalopathy, and most of these patients weresuccessfully managed conservatively. The cumulative survival rates at 1, 6, 12, and 24 months were 87.5%, 75.0%,66.8%, and 57.5%, respectively. A high Model for End-Stage Liver Disease (MELD) score was significantly associatedwith the risk of death within the first month after receiving a TIPS (P=0.018). Old age (P<0.001), indication for a TIPS(ascites vs. bleeding, P=0.005), low serum albumin (P<0.001), and high MELD score (P=0.006) were associated withoverall mortality. Conclusions: A high MELD score was found to be significantly associated with early and overall mortality rate in TIPSpatients. Determining the appropriate indication is warranted to improve survival in these patients.
URI
https://www.e-cmh.org/journal/view.php?doi=10.3350/cmh.2014.20.1.18
ISSN
2287-2728; 2287-285X
DOI
10.3350/cmh.2014.20.1.18
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COLLEGE OF MEDICINE[S](의과대학) > ETC
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