TY - JOUR
T1 - Transjugular intrahepatic portosystemic shunt
T2 - Indications, complications, survival and its use as a bridging therapy to liver transplant in Western Australia
AU - Pateria, Puraskar
AU - Jeffrey, Gary P.
AU - Garas, George
AU - Tibballs, Jonathan
AU - Ferguson, John
AU - Delriviere, Luc
AU - Huang, Yi
AU - Adams, Leon A.
AU - MacQuillan, Gerry
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Introduction: Insertion of transjugular intrahepatic portosystemic shunt (TIPS) is an established therapeutic option to treat the complications of portal hypertension. The purpose of this study is to review the experience of a single Australian institute with TIPS and evaluation of result to emphasize the indication, aetiology of portal hypertension, prognostic factors, complications and survival. Use of TIPS as a bridge to liver transplantation was also analysed. Method: A retrospective cohort study of patients treated with TIPS at The Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, over a period of 12 years. Kaplan–Meier method was used for survival analysis and cox-regression analysis was used to analyse the predictors of survival. Results: Fifty-three patients underwent TIPS between January 2000 and March 2012. The cumulative survival at 1 month, 1 year and 5 years was 90%, 70.9% and 43.9%, respectively. The predictors of survival were indication (variceal bleeding versus ascites, hazard ratio 3.19, CI 95%: 1.164–8.794, P = 0.024) and Model of End Stage Liver Disease score (Hazard ratio 2.513, CI 95%: 1.087–5.810, P = 0.031). Patients who underwent TIPS as a bridge to liver transplant had a 5-year survival of 71% that is comparable to the overall survival of Western Australian liver transplant unit. Conclusion: Transjugular intrahepatic portosystemic shunt is a safe and effective method of treatment of complications of portal hypertension. TIPS can be safely used as a bridging therapy to liver transplant. Despite small number of TIPS being performed at our institute, our technical results are comparable to the institutes with bigger number of patients.
AB - Introduction: Insertion of transjugular intrahepatic portosystemic shunt (TIPS) is an established therapeutic option to treat the complications of portal hypertension. The purpose of this study is to review the experience of a single Australian institute with TIPS and evaluation of result to emphasize the indication, aetiology of portal hypertension, prognostic factors, complications and survival. Use of TIPS as a bridge to liver transplantation was also analysed. Method: A retrospective cohort study of patients treated with TIPS at The Western Australian Liver Transplant Unit, Sir Charles Gairdner Hospital, over a period of 12 years. Kaplan–Meier method was used for survival analysis and cox-regression analysis was used to analyse the predictors of survival. Results: Fifty-three patients underwent TIPS between January 2000 and March 2012. The cumulative survival at 1 month, 1 year and 5 years was 90%, 70.9% and 43.9%, respectively. The predictors of survival were indication (variceal bleeding versus ascites, hazard ratio 3.19, CI 95%: 1.164–8.794, P = 0.024) and Model of End Stage Liver Disease score (Hazard ratio 2.513, CI 95%: 1.087–5.810, P = 0.031). Patients who underwent TIPS as a bridge to liver transplant had a 5-year survival of 71% that is comparable to the overall survival of Western Australian liver transplant unit. Conclusion: Transjugular intrahepatic portosystemic shunt is a safe and effective method of treatment of complications of portal hypertension. TIPS can be safely used as a bridging therapy to liver transplant. Despite small number of TIPS being performed at our institute, our technical results are comparable to the institutes with bigger number of patients.
KW - ascites
KW - encephalopathy
KW - liver transplantation
KW - oesophageal varices
KW - porto-systemic shunt
UR - http://www.scopus.com/inward/record.url?scp=85026880326&partnerID=8YFLogxK
U2 - 10.1111/1754-9485.12563
DO - 10.1111/1754-9485.12563
M3 - Article
C2 - 28070962
AN - SCOPUS:85026880326
SN - 1754-9477
VL - 61
SP - 441
EP - 447
JO - Journal of Medical Imaging and Radiation Oncology
JF - Journal of Medical Imaging and Radiation Oncology
IS - 4
ER -