Long-Term Results and Quality of Life in Patients Treated with  Transjugular Intrahepatic Portosystemic Shunts

Zhuang, Zhen W.; Teng, Gao J; Jeffery, Robert F.; Gemery, John M.; d’Othée, Bertrand Janne; Bettmann, Michael A.

doi:10.2214/ajr.179.6.1791597

Cited by 42 publications

(35 citation statements)

References 31 publications

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“…Chronic encephalopathy was observed in 12 (16.7%) corroborating with literature with ratings from 5% to 20% (16) . Variceal rebleeding was observed in 23 (31.9%) cases matching the reports of Zhuang et al (30) (32.26%) and Rosado and Kamath (23) (32%). TIPS dysfunction/stenosis was observed in 19 (26.4%) of cases, lower indices than those found in most of the studies as Jabbour et al (14) (52%), Zhuang et al (30) (43.16%), Russo et al (24) (49%), Yoon et al (28) (45%) and Sanyal et al (25) (75%).…”

Section: Discussionsupporting

confidence: 85%

“…Variceal rebleeding was observed in 23 (31.9%) cases matching the reports of Zhuang et al (30) (32.26%) and Rosado and Kamath (23) (32%). TIPS dysfunction/stenosis was observed in 19 (26.4%) of cases, lower indices than those found in most of the studies as Jabbour et al (14) (52%), Zhuang et al (30) (43.16%), Russo et al (24) (49%), Yoon et al (28) (45%) and Sanyal et al (25) (75%). Acute infections were found in 15 (20.8%), acute kidney insufficiency in 11 (15.2%) and cardiologic complications with arrhythmia in 2 (2.9%) of cases, however these complications are not reported in indices in literature (4) .…”

Section: Discussionsupporting

confidence: 85%

“…Thus, global mortality rate is similar to or inferior when compared to long term studies as Yoon et al (28) (58.9%) and Tzeng et al (27) (77%). Yet, early mortality which independs on the follow-up period presents similar rating to those shown in literature as in Zhuang et al (30) (22.3%), Chalasani et al (5) (23.2%), Tzeng et al (27) (28%). In Kisilevzky's (17) study with 44 patients, no statistically significant difference in global mortality of patients who underwent TIPS was found when compared to those performed in elective indication or urgency, whose results corroborate those found in this study.…”

Section: Discussionsupporting

confidence: 85%

“…Zhuang et al (30) studies report early mortality of 23 (22.3%) from 103 patients. In a 2 ½ year follow-up, Jabbour et al (14) report global mortality in 21 (24.7%) from the 85 patients studied in the sample, being that 25 of these underwent urgency TIPS with mortality of 13 (52%) patients.…”

Section: Discussionmentioning

confidence: 97%

“…Zhuang et al (30) in a sample of 103 patients, report that rebleeding occurred in 30 (32.26%) patients, shunt acute thrombosis in 13 (13.6%) and stenosis in 41 (43.16%). Technical complications were reported in 5 (4.8%) patients including a case of stent migration to the right atrium.…”

Section: Discussionmentioning

confidence: 99%

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Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

Funes

Silva

Arroyo

et al. 2012

Arq. Gastroenterol.

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-Context -Transjugular intrahepatic portosystemic shunt (TIPS) is the non-surgical treatment option with low level of morbi-mortality and possibility of accomplishment in patients with severe hepatic dysfunction which aims at decompressing the portal system treating or reducing the portal hypertension complications. ). Global mortality occurred in 41 (60.3%). Conclusions -Mortality is directly related to clinical factors of patients, being Child-Pugh and MELD classifications predictors of mortality, with more impact in patients with Child-Pugh class C and MELD > 15. The complications found were similar to those described in the literature, although the dysfunction by stent stenosis (26.4%) was lower than in the most of the studies and the encephalopathy incidence (58.3%) was higher. Probably, the high incidence of encephalopathy is explained by the low incidence of stenosis. HEADINGS -Portasystemic shunt, transjugular intrahepatic. Hypertension, portal.Estudo não apresenta conflito de interesses.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

Funes

Silva

Arroyo

et al. 2012

Arq. Gastroenterol.

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Dietary fiber decreases ammonia levels in patients with cirrhosis

et al. 2005

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We read with interest the editorial on the correlation between hepatitis B virus (HBV) genotypes and outcome of HBV infection by Fung and Lok. 1 This article made a succinct outline of the epidemiology of HBV genotypes and their association with hepatitis B e antigen seroconversion, activity of liver disease, and response to treatment. We believe that this article will be helpful to hepatologists when facing the explosion of knowledge regarding HBV genotypes in the literature. However, the authors inferred from our previous data 2 that genotype B may be associated with accelerated progression to hepatocellular carcinoma (HCC). This may be somewhat misleading, and we would like to address some comments to clarify this issue.In Taiwan, our first cross-sectional study indicated that more than 50% of HBV-related HCC patients were infected with genotype B. In addition, genotype C was more prevalent in patients with HCC who were older than 50 years, whereas genotype B was more common in those with HCC who were age 50 years or younger. This predominance of genotype B was more substantial in younger patients with HCC, amounting to 90% in those age 35 years or younger, and most of them did not have cirrhosis.To confirm this preliminary observation from only 80 HCC patients, a further survey of 200 surgical cases showed that the prevalence of genotype C was indeed higher in older HCC patients, while that of genotype B was higher in young HCC patients. 3 This observation also extends to HBVrelated childhood HCC. In a recent study, we demonstrated that genotype B was still the major genotype (74%) in 26 children with HCC. 4 Taken together, these lines of evidence strongly suggest that certain genotype B subtypes or strains are associated with the earlier development of HCC in Taiwan.Thus, the genotype B strains in Taiwan may be different from those in Japan and China where HCC development is less frequent and occurs at an older stage in patients with genotype B. [5][6][7] We have proposed that genotype B can be divided into three phenotypes based on the rate of liver disease progression. 8 The first is the slowly progressive phenotype that is associated with a tendency for early hepatitis B e antigen seroconversion during a carrier's lifetime or in the course of chronic hepatitis, which subsequently leads to the low death rate from HCC. The second is the intermediately progressive phenotype that runs a typical natural course of chronic HBV infection with the development of HCC, usually in the patient's 50s. The third is the rapidly progressive phenotype that is associated with the development of HCC in young HBV carriers before they reach 40 years of age, even in the absence of cirrhosis.In summary, HBV genotypes do account for the heterogeneity in clinical manifestations and treatment response among patients with chronic hepatitis B in different parts of the world; however, the paradoxical findings of genotype predominance in HCC patients between Taiwan and other countries deserve further examinations. Reply:We thank ...

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Benefit of TIPS for patients with refractory or recidivant ascites: Serum bilirubin may make the difference

Gerbes¹,

Gülberg²

2004

Hepatology

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Long-Term Results and Quality of Life in Patients Treated with Transjugular Intrahepatic Portosystemic Shunts

Abstract: TIPS has positive efficacy both for controlling bleeding or ascites and for improving the quality of life. The precise impact of TIPS on long-term survival, however, requires further clarification.

Cited by 42 publications

References 31 publications

Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

Dietary fiber decreases ammonia levels in patients with cirrhosis

Benefit of TIPS for patients with refractory or recidivant ascites: Serum bilirubin may make the difference

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