Effect of a transjugular intrahepatic portosystemic shunt on liver biochemical profiles.
OBJECTIVE
Transjugular intrahepatic portosystemic shunts (TIPS) have markedly simplified the care of patients with refractory variceal bleeding. Follow-up of liver biochemical profiles, however, has not been done in a prospective fashion.


METHODS
Twenty-nine patients undergoing TIPS placement for refractory variceal bleeding underwent serial laboratory tests and assessment of encephalopathy to determine the effect of TIPS. Prothrombin time and aspartate aminotransferase, alanine aminotransferase, total bilirubin, alkaline phosphatase, serum albumin, serum creatinine, and venous ammonia levels were checked prior to the procedure, at the time of discharge, and at 3 weeks, 3 months, and 6 months following the procedure.


RESULTS
There was no statistically significant change in any of the obtained laboratory values at up to 6 months of follow-up. The change in aspartate aminotransferase level approached but did not reach statistical significance at the time of discharge and was thought to be secondary to hepatocellular trauma associated with the procedure. New onset of encephalopathy occurred in 18.2% of patients and was easily controlled with medical therapy.


CONCLUSIONS
TIPS does not appear to have a significant effect on the liver biochemical profile with short-term follow-up. Hepatic encephalopathy does occur, however, in a significant number of patients but is easily controlled with medical therapy.
Crippin
J S
JS
Department of Radiology, Baylor University Medical Center, Dallas, TX 75246, USA.
Schmidt
R D
RD
Niblett
R L
RL
Rees
C R
CR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000032:analysis; D000469:Alkaline Phosphatase / Q000032:analysis; D000641:Ammonia / Q000097:blood; D001219:Aspartate Aminotransferases / Q000032:analysis; D001663:Bilirubin / Q000032:analysis; D003404:Creatinine / Q000097:blood; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000601:surgery; D006501:Hepatic Encephalopathy / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007601:Jugular Veins; D008099:Liver / Q000201:enzymology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D011517:Prothrombin Time; D012709:Serum Albumin / Q000032:analysis
D012709:Serum Albumin; D000641:Ammonia; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase; D001663:Bilirubin