TY - JOUR
T1 - Impact of Tips Preliver Transplantationfor the Outcome Posttransplantation
AU - Calvaruso, Vincenza
AU - Maimone, Sergio
AU - Xirouchakis, Elias
AU - Calvaruso, Vincenza
AU - Pleguezuelo, Maria
AU - Burroughs, Andrew K.
AU - Rolando, null
AU - Patch, David
AU - Rolles, null
AU - Davidson, null
AU - Guerrini, Gian Piero
PY - 2009
Y1 - 2009
N2 - The effects of transjugular intrahepatic portocavalshunt (TIPS) on the survival of grafts and patients afterliver transplantation (LTx) have only been documentedin small series and with only a comparativedescription with non-TIPS recipients. We evaluated 61TIPS patients who had a subsequent LTx and comparedthese with 591 patients transplanted with cirrhosiswithout TIPS. Pretransplant characteristicsweresimilar between groups. Graft survival at 1, 3 and5 years post-LTx was 85.2%, 77% and 72.1% (TIPS) and75.3%, 69.8% and 66.1% (controls). Patient survival atthe same points was 91.7%, 85% and 81.7%, respectively(TIPS) and 85.4%, 80.3% and 76.2% (controls).Cox regression showed the absence of TIPS pre-LTx,transfusion of >5 units of blood during LTx, intensivecare unit (ICU) stay post-LTx >3 days and earlier periodof transplant to be significantly associated with aworse patient and graft survival at 1 year. Migration ofthe TIPS stent occurred in 28% of cases, increasing thetime on bypass during LTx, but was not related to graftor patient survival. TIPS may improve portal supply tothe graft and reduce collateral flow, improving function.This may account for the improved adjusted graftand patient survival by Cox regression at 12 months.Long-term survival was not affected.
AB - The effects of transjugular intrahepatic portocavalshunt (TIPS) on the survival of grafts and patients afterliver transplantation (LTx) have only been documentedin small series and with only a comparativedescription with non-TIPS recipients. We evaluated 61TIPS patients who had a subsequent LTx and comparedthese with 591 patients transplanted with cirrhosiswithout TIPS. Pretransplant characteristicsweresimilar between groups. Graft survival at 1, 3 and5 years post-LTx was 85.2%, 77% and 72.1% (TIPS) and75.3%, 69.8% and 66.1% (controls). Patient survival atthe same points was 91.7%, 85% and 81.7%, respectively(TIPS) and 85.4%, 80.3% and 76.2% (controls).Cox regression showed the absence of TIPS pre-LTx,transfusion of >5 units of blood during LTx, intensivecare unit (ICU) stay post-LTx >3 days and earlier periodof transplant to be significantly associated with aworse patient and graft survival at 1 year. Migration ofthe TIPS stent occurred in 28% of cases, increasing thetime on bypass during LTx, but was not related to graftor patient survival. TIPS may improve portal supply tothe graft and reduce collateral flow, improving function.This may account for the improved adjusted graftand patient survival by Cox regression at 12 months.Long-term survival was not affected.
KW - Liver transplantation
KW - TIPS
KW - portal hypertension
KW - Liver transplantation
KW - TIPS
KW - portal hypertension
UR - http://hdl.handle.net/10447/44674
M3 - Article
VL - 2009
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
ER -