title: Outcomes of transjugular intrahepatic portosystemic shunts for ascites.
abstract: Refractory ascites represents a devastating complication of portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an efficacious option for patients for whom transplant is not an immediate option. Techniques to optimize the hepatic venous pressure gradient and the use of covered stents have reduced rates of hepatic encephalopathy and stent occlusion, respectively. Patients with a Model for End-Stage Liver Disease score less than 15, serum creatinine less than 2 mg/dL, and serum bilirubin less than 2 mg/dL are particularly suited for TIPS placement. TIPS is also effective for hepatic hydrothorax and for massive ascites in the posttransplant setting, although future investigations are necessary to elucidate risk factors and establish the effect on transplant-free survival.
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: Bercu
authors.affiliation: Department of Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Fischman
keywords: hepatic hydrothorax; interventional radiology; liver transplant; portal hypertension; refractory ascites; transjugular intrahepatic portosystemic shunt