Dynamic changes in liver function after transjugular intrahepatic portosystemic shunt in patients with cirrhosis

Abstract

Purpose: To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with cirrhosis and to explore its association with clinical outcomes. Methods: This retrospective study included patients who underwent TIPS between August 2016 and December 2020. Liver function was primarily evaluated using the model for end-stage liver disease (MELD) score, which was analyzed at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months using one-way repeated measures ANOVA. The Kaplan-Meier method, log-rank test, and multivariate analysis were used as appropriate. Results: In total, 235 patients were included in this study. The MELD score was significantly higher at 1 week (11.8 ​± ​3.1 vs 13.5 ​± ​3.5, p ​ ​0.05). At 12 months, the MELD score was higher than the baseline level (11.8 ​± ​3.1 vs 12.4 ​± ​3.2, p ​< ​0.05). Patients with a recovery of the MELD score (n ​= ​151) at 3 months had a lower probability of overt and severe HE (log-rank p ​= ​0.015 and p ​= ​0.027, respectively) than those without recovery (n ​= ​84). Logistic regression analysis revealed that albumin (odds ratio [OR], 0.926; 95% confidence interval [CI], 0.863–0.992; p ​= ​0.029) and platelet count (OR, 0.993; 95% CI, 0.987–0.999; p ​= ​0.033) were independent predictive factors for non-recovery of the MELD score at 3 months. Conclusions: Liver function after TIPS creation showed a trend of deterioration at first, followed by recovery. Recovery of liver function at three months was associated with reduced overt and severe HE.

Keywords

• Transjugular intrahepatic portosystemic shunt
• Liver function
• Cirrhosis
• Model for end-stage liver disease