Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2023; 29(38): 5383-5394
Published online Oct 14, 2023. doi: 10.3748/wjg.v29.i38.5383
Impressive recompensation in transjugular intrahepatic portosystemic shunt-treated individuals with complications of decompensated cirrhosis based on Baveno VII criteria
Long Gao, Man-Biao Li, Jin-Yu Li, Yang Liu, Chao Ren, Dui-Ping Feng
Long Gao, Jin-Yu Li, Dui-Ping Feng, Department of Oncological and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Long Gao, Jin-Yu Li, Dui-Ping Feng, Shanxi Provincial Clinical Research Center for Interventional Medicine, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Man-Biao Li, Yang Liu, Chao Ren, College of Medical Imaging, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Gao L, Li MB, and Li JY contributed equally to this manuscript; Gao L, Li MB, Li JY and Feng DP contributed to study conception and design; Li MB, Liu Y, and Ren C contributed to data acquisition; Li MB, Gao L, Li JY, and Feng DP contributed to analysis and interpretation of data; Gao L, Li MB, Li JY, and Feng DP contributed to manuscript writing, critical revision of the manuscript, and statistical analysis; All authors vouch for the veracity and completeness of the data and analyses presented, the final version of the manuscript has been reviewed and approved by all authors.
Supported by Natural Science Foundation of China, No. 82200650; Key Research and Development (R and D) Projects of Shanxi Province, No. 202102130501014; Shanxi Provincial Clinical Research Center for Interventional Medicine, No. 202204010501004; Natural Science Foundation of Shanxi Province, No. 202203021211021; Natural Science Foundation of Shanxi Province, No. 202203021212046; Natural Science Foundation of Shanxi Province, No. 20210302123258.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Hospital of Shanxi Medical University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dui-Ping Feng, MD, Chief Doctor, Department of Oncological and Vascular Intervention, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan 030001, Shanxi Province, China. fengdp@sxmu.edu.cn
Received: July 7, 2023
Peer-review started: July 7, 2023
First decision: August 8, 2023
Revised: August 15, 2023
Accepted: September 20, 2023
Article in press: September 20, 2023
Published online: October 14, 2023
Processing time: 97 Days and 1.2 Hours
Abstract
BACKGROUND

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard second-line treatment option for individuals with complications of decompensated cirrhosis, such as variceal bleeding and refractory ascites.

AIM

To investigate whether recompensation existed in TIPS-treated patients with decompensated cirrhosis according to Baveno VII criteria.

METHODS

This retrospective analysis was performed on 64 patients who received TIPS for variceal bleeding or refractory ascites. The definition of recompensation referred to Baveno VII criteria and previous study. Clinical events, laboratory tests, and radiological examinations were regularly conducted during a preset follow-up period. The recompensation ratio in this cohort was calculated. Beyond that, univariate and multivariate regression models were conducted to identify the predictors of recompensation.

RESULTS

Of the 64 patients with a 12-mo follow-up, 20 (31%) achieved recompensation. Age [odds ratio (OR): 1.124; 95% confidence interval (CI): 1.034-1.222] and post-TIPS portal pressure gradient < 12 mmHg (OR: 0.119; 95%CI: 0.024-0.584) were identified as independent predictors of recompensation in patients with decompensated cirrhosis after TIPS.

CONCLUSION

The present study demonstrated that nearly one-third of the TIPS-treated patients achieved recompensation within this cohort. According to our findings, recompensation is more likely to be achieved in younger patients. In addition, postoperative portal pressure gradient reduction below 12 mmHg contributes to the occurrence of recompensation.

Keywords: Liver cirrhosis; Cirrhosis recompensation; Complications; Portal hypertension; Transjugular intrahepatic portosystemic shunt; Predictors

Core Tip: Decompensated cirrhosis with complications of portal hypertension is often considered the end-stage of cirrhosis, with little chance of improvement. Despite this, recent studies have put forward the concept of recompensation. However, it remains unknown whether transjugular intrahepatic portosystemic shunts (TIPS) can achieve recompensation. Herein, we demonstrated that almost one-third of patients treated with TIPS achieved recompensation. Therefore, TIPS should be given greater priority in the treatment of decompensated cirrhosis with complications of portal hypertension, and prospective studies are necessary. In summary, the role of TIPS in achieving recompensation warrants further examination.