Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2025
Long-term outcomes of transjugular intrahepatic portosystemic shunt in Budd-Chiari syndrome: A multicenter study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Swaroop Shekhar, Janeela Asisha M, Valsan Arun, Biswas Sagnik, Alexander Vijay, Gamanagatti Shivanand, Gupta Sanchita, Goyal Ankur, Sharma Raju, Agarwal Samagra, Moorthy Srikant, Babu K B Santhosh, Keshava Shyamkumar N, S Sudhindran, Nair Gowripriya, Mohamed Zubair Umer, Nair Priya, Chavan Amitkumar, Chaudhary Swapnil, Aggarwal Arnav, Agarwal Ayush, Goel Ashish, Shalimar
Аннотация
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) is an important therapeutic option for Budd-Chiari syndrome (BCS), but long-term data are limited.
AIM: Evaluate response rates, long-term outcomes, complications, and predictors of mortality, new decompensation, hepatic encephalopathy (HE), and restenosis after TIPS.
METHODS: Retrospective analysis of symptomatic BCS patients who underwent TIPS at three centers in India (2010-2025) from a prospectively maintained database. We evaluated response rates, new decompensations (HE, variceal bleed, ascites), restenosis and survival outcomes and their predictors.
RESULTS: Among 318 patients (mean age 29.4 ± 9.8 years, 50.6 % males, median follow-up 4.4 years), 244 (76.7 %) had a clinical response to TIPS; non-response (23.3 %) was mainly persistent ascites (two re-bleeds). Of 282 with ascites at presentation, complete/partial resolution at 3-months was 75.2 %/17.0 %. New decompensation developed in 32.7 %, HE in 14.8 %, and restenosis in 33.6 %. Transplant-free survival at 1, 5, and 10 years were 95.5 %, 87.4 %, and 78.4 %, respectively. Predictors of mortality included non-response to TIPS, bilirubin, albumin, and HE at 3 months. Age, non-response to TIPS, creatinine, and albumin predicted new decompensation. Post-TIPS complications occurred in 8.2 %.
CONCLUSION: TIPS is a safe, effective intervention for symptomatic BCS, leading to high response rates and long-term survival. Non-response to TIPS and liver function identifies high-risk patients who should be evaluated for transplantation.
AIM: Evaluate response rates, long-term outcomes, complications, and predictors of mortality, new decompensation, hepatic encephalopathy (HE), and restenosis after TIPS.
METHODS: Retrospective analysis of symptomatic BCS patients who underwent TIPS at three centers in India (2010-2025) from a prospectively maintained database. We evaluated response rates, new decompensations (HE, variceal bleed, ascites), restenosis and survival outcomes and their predictors.
RESULTS: Among 318 patients (mean age 29.4 ± 9.8 years, 50.6 % males, median follow-up 4.4 years), 244 (76.7 %) had a clinical response to TIPS; non-response (23.3 %) was mainly persistent ascites (two re-bleeds). Of 282 with ascites at presentation, complete/partial resolution at 3-months was 75.2 %/17.0 %. New decompensation developed in 32.7 %, HE in 14.8 %, and restenosis in 33.6 %. Transplant-free survival at 1, 5, and 10 years were 95.5 %, 87.4 %, and 78.4 %, respectively. Predictors of mortality included non-response to TIPS, bilirubin, albumin, and HE at 3 months. Age, non-response to TIPS, creatinine, and albumin predicted new decompensation. Post-TIPS complications occurred in 8.2 %.
CONCLUSION: TIPS is a safe, effective intervention for symptomatic BCS, leading to high response rates and long-term survival. Non-response to TIPS and liver function identifies high-risk patients who should be evaluated for transplantation.