ArticleJHEP reports : innovation in hepatology2019
Ascites control by TIPS is more successful in patients with a lower paracentesis frequency and is associated with improved survival.
Article in JHEP reports : innovation in hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- CIRSE Standards of Practice on Transjugular Intrahepatic Portosystemic Shunts.Cardiovascular and interventional radiology · 2024Guideline
- Machine learning-derived clinical phenotypes of ascites in cirrhosis: A multi-center latent class analysis with external validation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026Article
- Refractory Ascites and the Alfapump.Gastro hep advances · 2026Review
- [Position paper for the standardized use of transjugular intrahepatic portosystemic shunt (TIPS) in adults].Zeitschrift fur Gastroenterologie · 2025Article
- Article
- Risk of portal hypertensive complications preventable by TIPS in patients with ascites.JHEP reports : innovation in hepatology · 2025Article
- Clinical Trends and Hospital Mortality of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Germany: A Descriptive Analysis Between 2019 and 2023.Diagnostics (Basel, Switzerland) · 2025Article
- Minimal residual ascites 3 months after TIPS implantation implicates worse clinical outcomes in patients with cirrhosis.JHEP reports : innovation in hepatology · 2025Article
- Recompensation of Liver Cirrhosis by TIPS Reduces Epithelial Cell Death Markers, Translating Into Improved Clinical Outcome.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Determining the optimal portal pressure gradient after small-diameter TIPS for ascites: a retrospective study.Therapeutic advances in gastroenterology · 2025Article
- Article
- Preoperative TIPS and in-hospital mortality in patients with cirrhosis undergoing surgery.JHEP reports : innovation in hepatology · 2024Article
- Advances in the management of complications from cirrhosis.Gastroenterology report · 2024Review
- Validation of 4D flow cardiovascular magnetic resonance in TIPS stent grafts using a 3D-printed flow phantom.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2023Article
- Transjugular intrahepatic portosystemic shunt in decompensated cirrhotic patients in a tertiary hospital in southern Brazil.Revista da Associacao Medica Brasileira (1992) · 2023Observational
- [Expert consensus on transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Covered transjugular intrahepatic portosystemic stent-shuntWorld journal of clinical cases · 2022Article
- The role of transjugular intrahepatic portosystemic shunt in patients with portal hypertension: Advantages and pitfalls.Clinical and molecular hepatology · 2022Review
- Transjugular intrahepatic portosystemic shunt (TIPS) placement at index portal hypertensive decompensation (anticipant TIPS) in cirrhosis and the role of early intervention in variceal bleeding and ascites.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2021Article
- Cardiovascular magnetic resonance demonstrates structural cardiac changes following transjugular intrahepatic portosystemic shunt.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsRefractory ascites is the main reason for the implantation of a transjugular intrahepatic portosystemic shunt (TIPS) in liver cirrhosis, but ascites control by TIPS fails in a relevant proportion of cases. Here, we investigated whether routine parameters pre-TIPS can predict persistent ascites after TIPS implantation and whether persistent ascites predicts long-term clinical outcome.
methodsA detailed retrospective analysis of 128 patients receiving expanded polytetrafluoroethylene-covered stents for the treatment of refractory ascites was performed. Persistent ascites post-TIPS was defined as the prolonged need for paracentesis >3 months after TIPS. The influence of demographics, laboratory results, pre-TIPS heart and liver ultrasound results, and invasive hemodynamic parameters on persistent ascites was evaluated by univariable and multivariable logistic regression. Predictors of the composite endpoint liver transplantation/death were analyzed using a multivariable Cox regression.
resultsAscites control post-TIPS was achieved in 95/128 patients (74%), whereas ascites remained persistent in 33/128 cases (26%). On multivariable analysis, a lower paracentesis frequency pre-TIPS (odds ratio 1.672; 95% CI 1.253-2.355) and lower baseline creatinine levels (odds ratio 2.640; CI 1.201-6.607) were associated with ascites control. Patients with persistent ascites post-TIPS had and impaired transplant-free survival (median 10.0
conclusionTIPS-placement in patients with lower paracentesis frequency and creatinine levels is associated with superior ascites control. Thus, TIPS implantation should be considered in moderate decompensation and not as a last resort. Persistent ascites post-TIPS seems to be the only predictor of liver transplantation and death. LAY SUMMARY: The insertion of a transjugular intrahepatic portosystemic shunt (TIPS) in patients with refractory ascites should be considered in patients with moderate decompensation and not as a last resort, as lower paracentesis frequency and creatinine levels pre-TIPS are associated with superior ascites control. In turn, failure to control ascites seems to be the only predictor of liver transplantation and death.
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