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Transjugular intrahepatic portosystemic shunt: Indications, complications, survival and its use as a bridging therapy to liver transplant in Western Australia
Author(s) -
Pateria Puraskar,
Jeffrey Gary P,
Garas George,
Tibballs Jonathan,
Ferguson John,
Delriviere Luc,
Huang Yi,
Adams Leon A,
MacQuillan Gerry
Publication year - 2017
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12563
Subject(s) - medicine , transjugular intrahepatic portosystemic shunt , ascites , portal hypertension , liver transplantation , hazard ratio , proportional hazards model , surgery , cirrhosis , retrospective cohort study , cohort , liver disease , portosystemic shunt , survival analysis , gastroenterology , transplantation , confidence interval
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.