In:
United European Gastroenterology Journal, Wiley, Vol. 5, No. 8 ( 2017-12), p. 1100-1107
Abstract:
Transjugular intrahepatic portosystemic shunt (TIPS) implantation is used for treatment of several complications in patients with liver cirrhosis. Recent studies have identified a survival benefit for patients on the waiting list after TIPS implantation, but the optimal time point for TIPS implantation prior to orthotopic liver transplantation (OLT) has not been established. Study This study retrospectively assessed patients undergoing TIPS implantation before or after listing for OLT at the Medical University of Vienna. n = 98 patients with TIPS on the waiting list between January 1993 and December 2013 were identified ( n = 73 (74.5%) pre‐listing TIPS, n = 25 (25.5%) post‐listing TIPS). A matched control group at the time of OLT without TIPS ( n = 60) was included. Results More patients with post‐listing TIPS (28.0%, 7/25) showed clinical improvement and went off‐list than patients with pre‐listing TIPS (8.2%, 6/73, p = .0119). A similar proportion of patients with pre‐listing TIPS (19.2%, 14/73) and post‐listing TIPS (20.0%, 5/25) died on the OLT waiting list. Transplant surgery time was similar in patients with and without TIPS: 348(±13) vs. 337(±10) minutes ( p = .5139). Estimated 1‐year post‐transplant survival was similar across all groups (pre‐listing TIPS: 76.2%, post‐listing TIPS: 86.0%, no TIPS: 91.2%, log‐rank p = .1506). Conclusion TIPS should be considered in all liver transplant candidates, since it can obviate the need for OLT and optimize bridging to OLT.
Type of Medium:
Online Resource
ISSN:
2050-6406
,
2050-6414
DOI:
10.1177/2050640617704807
Language:
English
Publisher:
Wiley
Publication Date:
2017
detail.hit.zdb_id:
2728585-6
