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Clin Mol Hepatol. 2014 Mar;20(1):18-27. English. Original Article.
Kim HK , Kim YJ , Chung WJ , Kim SS , Shim JJ , Choi MS , Kim DY , Jun DW , Um SH , Park SJ , Woo HY , Jung YK , Baik SK , Kim MY , Park SY , Lee JM , Kim YS .
Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea. liverkys@schmc.ac.kr
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea.
Department of Internal Medicine, Ajou University Hospital, Ajou University College of Medicine, Suwon, Korea.
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Inje University College of Medicine, Busan, Korea.
Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea.
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea.
Department of Radiology, Soonchunhyang University College of Medicine, Bucheon, Korea.
Abstract

BACKGROUND/AIMS: This retrospective study assessed the clinical outcome of a transjugular intrahepatic portosystemic shunt (TIPS) procedure for managing portal hypertension in Koreans with liver cirrhosis. METHODS: Between January 2003 and July 2013, 230 patients received a TIPS in 13 university-based hospitals. RESULTS: Of the 229 (99.6%) patients who successfully underwent TIPS placement, 142 received a TIPS for variceal bleeding, 84 for refractory ascites, and 3 for other indications. The follow-up period was 24.9+/-30.2 months (mean+/-SD), 74.7% of the stents were covered, and the primary patency rate at the 1-year follow-up was 78.7%. Hemorrhage occurred in 30 (21.1%) patients during follow-up; of these, 28 (93.3%) cases of rebleeding were associated with stent dysfunction. Fifty-four (23.6%) patients developed new hepatic encephalopathy, and most of these patients were successfully managed conservatively. The cumulative survival rates at 1, 6, 12, and 24 months were 87.5%, 75.0%, 66.8%, and 57.5%, respectively. A high Model for End-Stage Liver Disease (MELD) score was significantly associated with the risk of death within the first month after receiving a TIPS (P=0.018). Old age (P<0.001), indication for a TIPS (ascites vs. bleeding, P=0.005), low serum albumin (P<0.001), and high MELD score (P=0.006) were associated with overall mortality. CONCLUSIONS: A high MELD score was found to be significantly associated with early and overall mortality rate in TIPS patients. Determining the appropriate indication is warranted to improve survival in these patients.

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