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. Shaw; Karen Taylor; Cherie Bremer-Kamp; Tommie Sue Tralka; James Everhart; Jay H. Hoofnagle

doi:10.1097/00007890-199704270-00005

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

Gastroenterology and Hepatology

Research output: Contribution to journal › Article › peer-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 language	English (US)
Pages (from-to)	1074-1079
Number of pages	6
Journal	Transplantation
Volume	63
Issue number	8
DOIs	https://doi.org/10.1097/00007890-199704270-00005
State	Published - Apr 27 1997

ASJC Scopus subject areas

Transplantation

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Somberg, K. A., Lombardero, M. S., Lawlor, S. M., Ascher, N. L., Lake, J. R., Wiesner, R. H., Zetterman, R. K., Detre, K. M., Demetris, A. J., Belle, S. H., Wei, Y. L., Seaberg, E., Eng, H., FitzGerald, S., Haber, J., Swanson, G. L., Krom, R. A. F., Porayko, M. K., Schwerman, L., ... Hoofnagle, J. H. (1997). A controlled analysis of the transjugular intrahepatic portosystemic shunt in liver transplant recipients. Transplantation, 63(8), 1074-1079. https://doi.org/10.1097/00007890-199704270-00005

Somberg, KA, Lombardero, MS, Lawlor, SM, Ascher, NL, Lake, JR, Wiesner, RH, Zetterman, RK, Detre, KM, Demetris, AJ, Belle, SH, Wei, YL, Seaberg, E, Eng, H, FitzGerald, S, Haber, J, Swanson, GL, Krom, RAF, Porayko, MK, Schwerman, L, Shaw, BW, Taylor, K, Bremer-Kamp, C, Tralka, TS, Everhart, J & Hoofnagle, JH 1997, 'A controlled analysis of the transjugular intrahepatic portosystemic shunt in liver transplant recipients', Transplantation, vol. 63, no. 8, pp. 1074-1079. https://doi.org/10.1097/00007890-199704270-00005

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title = "A controlled analysis of the transjugular intrahepatic portosystemic shunt in liver transplant recipients",

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.",

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

year = "1997",

month = apr,

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doi = "10.1097/00007890-199704270-00005",

language = "English (US)",

volume = "63",

pages = "1074--1079",

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T1 - A controlled analysis of the transjugular intrahepatic portosystemic shunt in liver transplant recipients

AU - Somberg, Kenneth A.

AU - Lombardero, Manuel S.

AU - Lawlor, Sharon M.

AU - Ascher, Nancy L.

AU - Lake, John R.

AU - Wiesner, Russell H.

AU - Zetterman, Rowen K.

AU - Detre, Katherine M.

AU - Demetris, A. Jake

AU - Belle, Steven H.

AU - Wei, Yuling L.

AU - Seaberg, Eric

AU - Eng, Heather

AU - FitzGerald, Shannon

AU - Haber, Jacqueline

AU - Swanson, Gerald L.

AU - Krom, Ruud A.F.

AU - Porayko, Michael K.

AU - Schwerman, Lori

AU - Shaw, Byers W.

AU - Taylor, Karen

AU - Bremer-Kamp, Cherie

AU - Tralka, Tommie Sue

AU - Everhart, James

AU - Hoofnagle, Jay H.

PY - 1997/4/27

Y1 - 1997/4/27

N2 - 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.

AB - 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.

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

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