ArticleJournal of clinical and experimental hepatology
Liver Transplant Outcomes in Patients With Transjugular Intrahepatic Portosystemic Shunt: A Retrospective Cohort Study With Propensity Score Analysis.
Article in Journal of clinical and experimental hepatology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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16 authors.
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Abstract
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is used to manage portal hypertension-related complications in patients awaiting liver transplantation. However, the role of pretransplant TIPS placement remains controversial. Methods: We conducted a retrospective, single-center cohort study to evaluate the impact of pretransplant TIPS on postoperative complications and in-hospital mortality. Results: We included 263 cirrhotic patients who underwent liver transplantation from deceased donors between 2015 and 2023. Twenty-three patients (8.7%) underwent pretransplant TIPS placement. All TIPS were placed using controlled-expansion stents, with a median diameter of 8 ± 1 mm. Stent migration was identified intraoperatively in 7 patients (30.4%) and was associated with increased surgical complexity. After propensity score weighting, pretransplant TIPS was not independently associated with operative time, use of venovenous bypass, transfusion requirements, length of intensive care unit (ICU) or hospital stay, comprehensive complication index, major complications (Clavien-Dindo ≥ III), or in-hospital mortality. Conversely, reoperation rates were higher in the TIPS group (17.4% vs. 8.0%, Conclusions: Pretransplant TIPS may allow patients with severe portal hypertension to achieve postoperative outcomes comparable to those without TIPS, but should be reserved for guideline-supported indications, given the lack of demonstrated survival benefit.
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