title: Role of Transjugular Intrahepatic Portosystemic Shunts in the Management of Hepatopulmonary Syndrome: A Systemic Literature Review.
abstract: OBJECTIVE
  To evaluate the role of transjugular intrahepatic portosystemic shunt (TIPS) creation in the management of hepatopulmonary syndrome (HPS).
  
  
  METHODS
  A MEDLINE (PubMed) search from January 1990 to April 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was restricted to the English language and human subjects. Inclusion criteria were patients with HPS who underwent TIPS creation for any indication. Exclusion criteria was age < 18 years.
  
  
  RESULTS
  Ten studies consisting of 12 patients with HPS were included. Eight patients had very severe HPS, 2 had severe HPS, and 2 had moderate HPS. Transjugular intrahepatic portosystemic shunt creation was technically successful in all patients, without complications. Mean portosystemic pressure gradients before and after the procedure were 18.2 mm Hg (range, 10-30 mm Hg) and 6.5 mm Hg (range, 3-15 mm Hg), respectively. The mean duration of follow-up was 9.3 months (range, 0.75-36 mo). Improvement in oxygenation occurred in 9 patients but was not sustained after 4 months in 2 patients. In the remaining 3 patients, oxygenation remained unchanged; it worsened after 4 months in 1 patient. Four patients underwent liver transplantation. Two patients died of multiple organ dysfunction syndrome and 1 died of sepsis. The remaining patients were alive and well at the time of last follow-up.
  
  
  CONCLUSIONS
  Transjugular intrahepatic portosystemic shunt creation shows promise in the management of HPS. Future prospective studies are warranted.
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.; Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.
authors.forename: Jiaywei
authors.initials: J
authors.lastname: Tsauo
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.; Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.
authors.forename: Ningna
authors.initials: N
authors.lastname: Weng
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.; Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.
authors.forename: Huaiyuan
authors.initials: H
authors.lastname: Ma
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.; Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.
authors.forename: Mingshan
authors.initials: M
authors.lastname: Jiang
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.; Department of Gastroenterology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.
authors.forename: He
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Institute of Interventional Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu 610041, Sichuan, China.. Electronic address: simonlixiao@gmail.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
mesh_terms: D000328:Adult; D020065:Hepatopulmonary Syndrome / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects* / Q000379:methods*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult