Clinical outcome of liver cirrhosis patients with different complications treated by TIPS

Abstract

Abstract: Objective To investigate the clinical outcome of liver cirrhosis patients with different complications treated by transjugular intrahepatic portosystemic shunt (TIPS) and investigate the best indications of TIPS for patients with cirrhosis. Methods A total of 80 patients with liver cirrhosis and portal hypertension treated by TIPS were included, they were divided into refractory ascites (RA) group and variceal bleeding (VB) group according to the complication. Clinical data including age, sex, Child score and the model for end-stage liver disease score (MELD score) were collected and analyzed. The Kaplan Meier method was used to calculate survival rate and log rank test was used to compare the survival condition. Results There was no significant difference of age (VB group: 61.4±10.3 years,RA group: 63.5±10.5 years), sex (male/female in VB group: 32/20, male/female in RA group: 15/13), Child score (level A/ level B/ level C in VB group: 24/26/2, level A/ level B/ level C in RA group: 7/18/3) or MELD score (VB group: 11.35±4.4,RA group: 13.2±5.3) between the 2 groups. The median survival times of RA and VB group were 28 months and 60 months respectively, and the difference was significant (P=0.008). After TIPS implantation, the average survival time of patients without stent occlusion (>60 months) was significantly higher than patients with stent occlusion (50 months), (P=0.025). The average survival time of patients with MELD score≤10 (51.3 months) was significantly higher than patients with MELD score>10 (36.1 months), (P=0.001). Overall survival curve showed there was a gradual decline of postoperative survival rates in patients with liver cirrhosis after the TIPS and survival rate was 45.3% at 60-month follow-up.Conclusion Compared to patients with liver cirrhosis and RA, patients with liver cirrhosis and VB benefit more from TIPS. In addition, stent occlusion and MELD score >10 are influencing factors of the survival time in patients with liver cirrhosis treated by TIPS.

Key words: Transjugular intrahepatic portosystemic shunt, Refractory ascites, Variceal bleeding, Outcome, Indications

YAO Yong, FENG Lei, LIU Tian-yu, LIU Jie, PAN Jin. Clinical outcome of liver cirrhosis patients with different complications treated by TIPS[J]. Chinese Hepatolgy, 2023, 28(1): 61-64.

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