title: Pathological Predictors of Shunt Stenosis and Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt.
abstract: Background.Transjugular intrahepatic portosystemic shunt (TIPS) is an artificial channel from the portal vein to the hepatic vein or vena cava for controlling portal vein hypertension. The major drawbacks of TIPS are shunt stenosis and hepatic encephalopathy (HE); previous studies showed that post-TIPS shunt stenosis and HE might be correlated with the pathological features of the liver tissues. Therefore, we analyzed the pathological predictors for clinical outcome, to determine the risk factors for shunt stenosis and HE after TIPS.Methods.We recruited 361 patients who suffered from portal hypertension symptoms and were treated with TIPS from January 2009 to December 2012.Results.Multivariate logistic regression analysis showed that the risk of shunt stenosis was increased with more severe inflammation in the liver tissue (OR, 2.864; 95% CI: 1.466-5.592;P= 0.002), HE comorbidity (OR, 6.266; 95% CI, 3.141-12.501;P< 0.001), or higher MELD score (95% CI, 1.298-1.731;P< 0.001). Higher risk of HE was associated with shunt stenosis comorbidity (OR, 6.266; 95% CI, 3.141-12.501;P< 0.001), higher stage of the liver fibrosis (OR, 2.431; 95% CI, 1.355-4.359;P= 0.003), and higher MELD score (95% CI, 1.711-2.406;P< 0.001).Conclusion.The pathological features can predict individual susceptibility to shunt stenosis and HE.
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Fuliang
authors.initials: F
authors.lastname: He
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Dai
authors.affiliation: Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China.
authors.forename: Zhibo
authors.initials: Z
authors.lastname: Xiao
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Zhendong
authors.initials: Z
authors.lastname: Yue
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Mengfei
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Internal Medicine, Section of Hematology-Oncology, Section of Gastroenterology, Stephenson Cancer Center, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
authors.forename: Qiushi
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China; Department of Internal Medicine, Section of Hematology-Oncology, Section of Gastroenterology, Stephenson Cancer Center, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
authors.forename: Xiaoqun
authors.initials: X
authors.lastname: Dong
authors.affiliation: Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, The 9th Affiliated Hospital of Peking University, Beijing 100038, China.
authors.forename: Fuquan
authors.identifier: 0000-0001-7710-6135
authors.initials: F
authors.lastname: Liu
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006501:Hepatic Encephalopathy / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome