title: Outcomes after transjugular intrahepatic portosystemic stent shunt: a "bridge" to nowhere.
abstract: BACKGROUND
  Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation.
  
  
  METHODS
  Patients undergoing TIPS from 2001 to 2010 at a teaching hospital with a transplant program were studied. The median data are presented.
  
  
  RESULTS
  TIPS was undertaken in 256 patients. TIPS decreased portal vein-inferior vena cava (IVC) gradients from 17 to 5 mm Hg (P < .001). Reinterventions were undertaken in 54 patients (21%). Survival after TIPS was 26 months; liver transplantation was undertaken in 35 (14%) patients.
  
  
  CONCLUSIONS
  TIPS effectively decompresses portal hypertension but leads to frequent reinterventions and short survival. After TIPS, liver transplantation is uncommonly undertaken. TIPS is a "bridge" to transplantation that is seldom "crossed," and TIPS continues to be plagued by frequent reinterventions. Outcomes after TIPS and the infrequency of transplantation after TIPS make it difficult to recommend on merit.
authors: University of South Florida, Department of Surgery, Tampa, FL, USA.
authors: Paul G
authors: PG
authors: Toomey
authors: Sharona B
authors: SB
authors: Ross
authors: Farhaad C
authors: FC
authors: Golkar
authors: Jonathan M
authors: JM
authors: Hernandez
authors: Whalen C
authors: WC
authors: Clark
authors: Kenneth
authors: K
authors: Luberice
authors: Angel E
authors: AE
authors: Alsina
authors: Alexander S
authors: AS
authors: Rosemurgy
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000401:mortality; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome