Annals of Hepatology (Dec 2024)
P-79 CHARACTERISTICS AND OUTCOMES OF TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT (TIPS) RECIPIENTS IN A TERTIARY HOSPITAL. LIMA - PERU (JANUARY 2019 - MARCH 2024)
Abstract
Conflict of interest: No Introduction and Objectives: Portal Hypertension (PHT) is the determining event of decompensations in liver cirrhosis, increasing its mortality. TIPS is an effective strategy for the management of PHT; however, in Latin America there are few studies on this topic. Objective: To describe characteristics and results of TIPS recipients in a tertiary hospital in Lima (Peru) from January 2019 to March 2024. Patients / Materials and Methods: This observational, retrospective and cross-sectional study reviewed all medical records of patients ≥ 18 years old undergoing TIPS between January 2019 and March 2024, performed by Interventional Radiology Service. For statistical analysis, SPSS 29 software was used. Results and Discussion: A total of 43 patients (46,5% male) were included, with a mean age of 52.3 years (SD14.9), most of them cirrhotic (93%), being MASLD the main etiology (45%). The mean Child Pugh score was B9, and the Model for End-stage Liver Disease (MELD) score was 12.45 (SD4.6).TIPS was mainly indicated for refractory/resistant ascites 39.5% (17/43) and variceal hemorrhage 27.9% (12/43), and there was more than one indication in 18.6% (8/43). The mean shunt diameter was 10mm with a pre-procedure pressure gradient of 23.5mmHg (range 12-40) and post-procedure pressure gradient of 7.44 (range 4-13).Technical success was achieved in 95.3% (shunt creation), hemodynamic success (GHPVH < 12mmHg or decrease ≥50%) in 100% and favorable clinical success (Table 1).It was found that 55.8% (24/43) had at least one complication, the main one being hepatic encephalopathy in 32.6% (14/43) and the most serious being hemoperitoneum in 9.3% (4/43).The average follow-up time was 11 months (1–56 months), showing that 16.27% of patients had access to liver transplantation. Conclusions: The main indication for TIPS in our setting was refractory ascites, followed by variceal hemorrhage, with high technical and hemodynamic success and favorable clinical response; the most common complication being hepatic encephalopathy.