ArticleJHEP reports : innovation in hepatology2022
Preoperative TIPS prevents the development of postoperative acute-on-chronic liver failure in patients with high CLIF-C AD score.
Article in JHEP reports : innovation in hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- A systematic review of preoperative transjugular intrahepatic portosystemic shunt prior to extrahepatic, abdominal surgery in patients with cirrhosis.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2024Pooled it
- Unlocking the potential of TIPS placement as a bridge to elective and emergency surgery in cirrhotic patients: a meta-analysis and future directions for endovascular resuscitation in acute care surgery.World journal of emergency surgery : WJES · 2023Pooled it
- Review
- Beyond the Tipping Point: Advances in the Diagnosis and Management of Acute-on-Chronic Liver Failure and End-Stage Liver Disease.Diagnostics (Basel, Switzerland) · 2026Review
- Recent Advances in the Diagnosis and Management of Clinically Significant Portal Hypertension in Liver Cirrhosis: A Clinical Review.Biomedicines · 2026Review
- Guidelines in Practice: Preoperative Risk Assessment and Management in Patients With Cirrhosis.The American journal of gastroenterology · 2026Article
- Neoadjuvant Under-Dilated TIPS: Expanding Surgeries for Extrahepatic Malignancies in Patients With Cirrhosis and CSPH.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- [Position paper for the standardized use of transjugular intrahepatic portosystemic shunt (TIPS) in adults].Zeitschrift fur Gastroenterologie · 2025Article
- Preventing the progression of cirrhosis to decompensation and death.Nature reviews. Gastroenterology & hepatology · 2025Review
- Prognosis algorithms for acute decompensation of cirrhosis and ACLF.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- The clinical relevance of acute-on-chronic liver failure in medical procedures: Endoscopy, interventions and surgery.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Acute-on-Chronic Liver Failure.Deutsches Arzteblatt international · 2025Review
- Use of Transjugular Intrahepatic Portosystemic Shunt (TIPS) to Provide for Safe Pancreaticoduodenectomy in Patients with Portal Hypertension.Journal of gastrointestinal cancer · 2025Article
- Transjugular Intrahepatic Portosystemic Shunt (TIPS): A Bridge to Bariatric Surgery in Morbidly Obese Patients with Cirrhosis and Clinically Significant Portal Hypertension.Obesity surgery · 2025Article
- Pre-Operative Assessment of Patients with Cirrhosis for Extrahepatic Surgery.Current hepatology reports · 2025Review
- Recent TIPS increases postoperative mortality: A national cohort study.Hepatology communications · 2024Article
- Construction of a novel prognostic scoring model for HBV-ACLF liver failure based on dynamic data.Scientific reports · 2024Article
- Navigating Complex Challenges: Preoperative Assessment and Surgical Strategies for Liver Resection in Patients with Fibrosis or Cirrhosis.Biomedicines · 2024Review
- Surgical risk stratification in patients with cirrhosis.Hepatology international · 2024Review
- Transjugular Intrahepatic Portosystemic Shunt as a Bridge to Abdominal Surgery in Cirrhosis.Journal of clinical medicine · 2024Review
Corrections and comments
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Authors and funding
13 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsAcute-on-chronic liver failure (ACLF) is a syndrome associated with organ failure and high short-term mortality. Recently, the role of surgery as a precipitating event for ACLF has been characterised. However, the impact of preoperative transjugular intrahepatic portosystemic shunt (TIPS) placement on ACLF development in patients with cirrhosis undergoing surgery has not been investigated yet.
methodsA total of 926 patients (363 with cirrhosis undergoing surgery and 563 patients with TIPS) were screened. Forty-five patients with preoperative TIPS (TIPS group) were 1:1 propensity matched to patients without preoperative TIPS (no-TIPS group). The primary endpoint was the development of ACLF within 28 and 90 days after surgery. The secondary endpoint was 1-year mortality. Results were confirmed by a differently 1:2 matched cohort (n = 176).
resultsPatients in the no-TIPS group had significantly higher rates of ACLF within 28 days (29
conclusionsThis study suggests that preoperative TIPS may result in lower rates of postoperative ACLF development especially in patients undergoing visceral surgery and with a CLIF-C AD score above 45. LAY SUMMARY: Acute-on-chronic liver failure (ACLF) is a syndrome that is associated with high short-term mortality. Surgical procedures are a known precipitating event for ACLF. This study investigates the role of preoperative insertion of a transjugular intrahepatic portosystemic shunt (TIPS) on postoperative mortality and ACLF development. Patients with TIPS insertion before a surgical procedure exhibit improved postoperative survival and lower rates of postoperative ACLF, especially in patients undergoing visceral surgery and with a high CLIF-C AD prognostic score. Thus, this study suggests preoperative TIPS insertion in those high-risk patients.
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