TY - JOUR
T1 - Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension
T2 - Korean multicenter real-practice data
AU - Kim, Hyung K.i.
AU - Kim, Yoon J.un
AU - Chung, Woo J.in
AU - Kim, Soon S.un
AU - Shim, Jae J.un
AU - Choi, Moon S.eok
AU - Kim, Do Y.oung
AU - Jun, Dae W.on
AU - Um, Soon H.o.
AU - Park, Sung J.ae
AU - Woo, Hyun Y.oung
AU - Jung, Young K.ul
AU - Baik, Soon K.oo
AU - Kim, Moon Y.oung
AU - Park, Soo Y.oung
AU - Lee, Jae M.yeong
AU - Kim, Young S.eok
PY - 2014/3/1
Y1 - 2014/3/1
N2 - BACKGROUND/AIMS: This retrospective study assessed the clinical outcome of a transjugular intrahepatic portosystemic 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 variceal bleeding, 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%. Hemorrhage occurred in 30 (21.1%) patients during follow-up; of these, 28 (93.3%) cases of rebleeding were associated with stent dysfunction. Fifty-four (23.6%) patients developed new hepatic encephalopathy, and most of these patients were successfully 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 associated with 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 with overall mortality.CONCLUSIONS: A high MELD score was found to be significantly associated with early and overall mortality rate in TIPS patients. Determining the appropriate indication is warranted to improve survival in these patients.
AB - BACKGROUND/AIMS: This retrospective study assessed the clinical outcome of a transjugular intrahepatic portosystemic 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 variceal bleeding, 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%. Hemorrhage occurred in 30 (21.1%) patients during follow-up; of these, 28 (93.3%) cases of rebleeding were associated with stent dysfunction. Fifty-four (23.6%) patients developed new hepatic encephalopathy, and most of these patients were successfully 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 associated with 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 with overall mortality.CONCLUSIONS: A high MELD score was found to be significantly associated with early and overall mortality rate in TIPS patients. Determining the appropriate indication is warranted to improve survival in these patients.
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U2 - 10.3350/cmh.2014.20.1.18
DO - 10.3350/cmh.2014.20.1.18
M3 - Article
C2 - 24757655
AN - SCOPUS:84921425089
SN - 2287-2728
VL - 20
SP - 18
EP - 27
JO - Clinical and Molecular Hepatology
JF - Clinical and Molecular Hepatology
IS - 1
ER -