A controlled analysis of the transjugular intrahepatic portosystemic shunt in liver transplant recipients

Kenneth A. Somberg, Manuel S. Lombardero, Sharon M. Lawlor, Nancy L. Ascher, John R. Lake, Russell H. Wiesner, Rowen K. Zetterman, Katherine M. Detre, A. Jake Demetris, Steven H. Belle, Yuling L. Wei, Eric Seaberg, Heather Eng, Shannon FitzGerald, Jacqueline Haber, Gerald L. Swanson, Ruud A.F. Krom, Michael K. Porayko, Lori Schwerman, Byers W. ShawKaren Taylor, Cherie Bremer-Kamp, Tommie Sue Tralka, James Everhart, Jay H. Hoofnagle

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Background. The transjugular intrahepatic portosystemic shunt (TIPS) is an important treatment for complications of portal hypertension. As some authors have suggested that TIPS may facilitate liver transplantation technically, the objective of this study was to determine the impact of TIPS on the liver transplant operation and its outcome. Methods. The analysis was designed as a retrospective cohort study using a multicenter database. Fifty- five patients with TIPS were matched with 55 controls on the basis of 10 pretransplant laboratory, clinical, and demographic features. TIPS patients and control patients were compared with regard to duration of surgery, intraoperative blood product usage, liver and renal function, volume of ascites, survival, and hospital stay. For confirmatory purposes, a parallel analysis using linear regression methods was performed. Results. By matched analysis, TIPS patients had less ascites at surgery (mean 0.9±0.20 vs. 2.2±0.37 L, P=0.005) and a slightly shorter time from incision to cross- clamp (mean 2.1±0.10 vs. 2.5±0.15 hr, P=0.03). However, there were not significant differences for total operative time (mean 6.0±0.17 vs. 6.3±0.25 hr. P=1.00), blood product usage, or any other outcome variable. Regression analysis confirmed these results. Conclusions. TIPS does not significantly impact the course of liver transplantation surgery. Therefore, preoperative portal decompression solely to facilitate liver transplantation is not an appropriate indication for TIPS.

Original languageEnglish (US)
Pages (from-to)1074-1079
Number of pages6
JournalTransplantation
Volume63
Issue number8
DOIs
StatePublished - Apr 27 1997

ASJC Scopus subject areas

  • Transplantation

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