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

• Published in: Clinical and molecular hepatology 2014, 20(1), , pp.18-27
• Main Authors: Kim, Hyung Ki, Kim, Yoon Jun, Chung, Woo Jin, Kim, Soon Sun, Shim, Jae Jun, Choi, Moon Seok, Kim, Do Young, Jun, Dae Won, Um, Soon Ho, Park, Sung Jae, Woo, Hyun Young, Jung, Young Kul, Baik, Soon Koo, Kim, Moon Young, Park, Soo Young, Lee, Jae Myeong, Kim, Young Seok
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Alcohol; Ascites; Asian Continental Ancestry Group; Clinical outcomes; Creatinine; Diuretics; End Stage Liver Disease - pathology; Endoscopy; Female; Follow-Up Studies; Hemorrhage - etiology; Hepatic Encephalopathy - etiology; Hepatitis; Hospitals, University; Humans; Hypertension; Hypertension, Portal - diagnosis; Hypertension, Portal - mortality; Hypertension, Portal - surgery; Kaplan-Meier Estimate; Liver cirrhosis; Liver diseases; Liver transplants; Male; Medical records; Middle Aged; Mortality; Multivariate analysis; Odds Ratio; Original; Patients; Portal hypertension; Portasystemic Shunt, Transjugular Intrahepatic; Republic of Korea; Retrospective Studies; Risk Factors; Severity of Illness Index; Statistical analysis; Stents; Survival Rate; Thrombosis; Transjugular intrahepatic portosystemic shunt; Treatment Outcome; Young Adult; 내과학
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2014.20.1.18

This retrospective study assessed the clinical outcome of a transjugular intrahepatic portosystemic shunt (TIPS) procedure for managing portal hypertension in Koreans with liver cirrhosis. Between January 2003 and July 2013, 230 patients received a TIPS in 13 university-based hospitals. 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