First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program

Abstract

Aim: Analysis of the first experience of transjugular intrahepatic portosystemic shunting (TIPS) in patients with liver cirrhosis at a multidisciplinary hospital with a liver transplantation program.Materials and methods: The authors examined 206 patients with liver cirrhosis from July 2019 to June 2021, with 20 of them undergoing TIPS. The mean age of the patients was 47.59 ± 9.55 years (35–65 years). Dynamic follow-up was performed at 3, 6, 9, 12, and 18 months. As a part of the dynamic follow-up, the patients underwent laboratory tests, abdomen ultrasound examination, and computed tomography imaging enhanced by the intravenous use of contrasting agent, endoscopy, esophagogastroduodenoscopy, and encephalopathy assessment.Results: No in-hospital TIPS-associated mortality has been reported. Two patients died in the hospital at the 19th and 26th day following the surgery because of the progression of liver failure, the 6-week mortality rate was 10%. In one patient (5%), an intraoperative complication was reported, i.e., intra-abdominal hemorrhage secondary to the migration of the stent under the liver capsule. The length of hospital stay after surgery was 7.34 ± 1.89 days (5–26 days). Long-term outcomes were available for 17 patients. The duration of the dynamic follow-up was 13.23 ± 2.47 months (3–24 months) and 2 (11,7%) deaths were reported. One patient (5.8%) was diagnosed with a shunt thrombosis at 12 months after the surgery. Three patients underwent liver transplantation after TIPS. The current one-year survival rate is 90%.Conclusion: TIPS is a safe and effective procedure decreasing mortality and improving quality of life of patients awaiting cadaveric liver transplantation. TIPS should be widely implemented in multidisciplinary hospitals having liver transplant program.