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Cited by 452Liver Disease and TransplantationOrgan Transplantation Techniques and OutcomesLiver Disease Diagnosis and Treatment

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Transjugular Intrahepatic Portosystemic Shunts With Covered Stents Increase Transplant-Free Survival of Patients With Cirrhosis and Recurrent Ascites

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Bureau, Christophe, Thabut, Dominique, Oberti, Frédéric, Dharancy, Sébastien, Carbonell, Nicolas, Bouvier, Antoine, Mathurin, Philippe, Otal, Philippe, Cabarrou, Pauline, Péron, Jean Marie, Vinel, Jean Pierre·2017·Gastroenterology
DOI 10.1053/j.gastro.2016.09.016
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Abstract

BACKGROUND & AIMS: There is controversy over the ability of transjugular intrahepatic portosystemic shunts (TIPS) to increase survival times of patients with cirrhosis and refractory ascites. The high rate of shunt dysfunction with the use of uncovered stents counteracts the benefits of TIPS. We performed a randomized controlled trial to determine the effects of TIPS with stents covered with polytetrafluoroethylene in these patients. METHODS: We performed a prospective study of 62 patients with cirrhosis and at least 2 large-volume paracenteses within a period of at least 3 weeks; the study was performed at 4 tertiary care centers in France from August 2005 through December 2012. Patients were randomly assigned to groups that received covered TIPS (n = 29) or large-volume paracenteses and albumin as necessary (LVP+A, n = 33). All patients maintained a low-salt diet and were examined at 1 month after the procedure then every 3 months until 1 year. At each visit, liver disease-related complications, treatment modifications, and clinical and biochemical variables needed to calculate Child-Pugh and Model for End-Stage Liver Disease scores were recorded. Doppler ultrasonography was performed at the start of the study and then at 6 and 12 months after the procedure. The primary study end point was survival without a liver transplant for 1 year after the procedure. RESULTS: A higher proportion of patients in the TIPS group (93%) met the primary end point than in the LVP+A group (52%) (P = .003). The total number of paracenteses was 32 in the TIPS group vs 320 in the LVP+A group. Higher proportions of patients in the LVP+A group had portal hypertension-related bleeding (18% vs 0%; P = .01) or hernia-related complications (18% vs 0%; P = .01) than in the TIPS group. Patients in LVP+A group had twice as many days of hospitalization (35 days) as the TIPS group (17 days) (P = .04). The 1-year probability of remaining free of encephalopathy was 65% for each group. CONCLUSIONS: In a randomized trial, we found covered stents for TIPS to increase the proportion of patients with cirrhosis and recurrent ascites who survive transplantation-free for 1 year, compared with patients given repeated LVP+A. These findings support TIPS as the first-line intervention in such patients. ClinicalTrials.gov ID: NCT00222014.

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Crossref · 10.1053/j.gastro.2016.09.016

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  • A recent randomised controlled trial showed that covered TIPS stents increase the proportion of cirrhotic patients with recurrent ascites surviving transplantation-free for 1 year compared with repeated large volume paracentesis.

    “TIPS has a role in the management of patients with refractory ascites, with a recent randomised controlled trial showing that covered TIPS stents increase the proportion of cirrhotic patients with recurrent ascites surviving transplantation-free for 1 year compared with repeated large volume paracentesis.241”

    From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [241]

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Research works printed but not linked: 25

  1. Ginés, 1987, Compensated cirrhosis: natural history and prognostic factors, Hepatology, 7, 122, 10.1002/hep.1840070124 · DOI
  2. Arroyo, 2003, Ascites and hepatorenal syndrome in cirrhosis: pathophysiological basis of therapy and current management, J Hepatol, 38, S69, 10.1016/S0168-8278(03)00007-2 · DOI
  3. European Association for the Study of the Liver, 2010, EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis, J Hepatol, 53, 397, 10.1016/j.jhep.2010.05.004 · DOI
  4. Bernardi, 2012, Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials, Hepatology, 55, 1172, 10.1002/hep.24786 · DOI
  5. Ochs, 1995, The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites, N Engl J Med, 332, 1192, 10.1056/NEJM199505043321803 · DOI
  6. Rössle, 2000, A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites, N Engl J Med, 342, 1701, 10.1056/NEJM200006083422303 · DOI
  7. Ginès, 2002, Transjugular intrahepatic portosystemic shunting vs paracentesis plus albumin for refractory ascites in cirrhosis, Gastroenterology, 123, 1839, 10.1053/gast.2002.37073 · DOI
  8. Sanyal, 2003, The North American Study for the Treatment of Refractory Ascites, Gastroenterology, 124, 634, 10.1053/gast.2003.50088 · DOI
  9. Salerno, 2004, Randomized controlled study of TIPS vs paracentesis plus albumin in cirrhosis with severe ascites, Hepatology, 40, 629, 10.1002/hep.20364 · DOI
  10. Narahara, 2011, Transjugular intrahepatic portosystemic shunt vs paracentesis plus albumin in patients with refractory ascites who have good hepatic and renal function: a prospective randomized trial, J Gastroenterol, 46, 78, 10.1007/s00535-010-0282-9 · DOI
  11. Lebrec, 1996, Transjugular intrahepatic portosystemic shunts: comparison with paracentesis in patients with cirrhosis and refractory ascites: a randomized trial. French Group of Clinicians and a Group of Biologists, J Hepatol, 25, 135, 10.1016/S0168-8278(96)80065-1 · DOI
  12. Angermayr, 2003, Survival in patients undergoing transjugular intrahepatic portosystemic shunt: ePTFE-covered stentgrafts vs bare stents, Hepatology, 38, 1043, 10.1002/hep.1840380431 · DOI
  13. Bureau, 2004, Improved clinical outcome using polytetrafluoroethylene-coated stents for TIPS: results of a randomized study, Gastroenterology, 126, 469, 10.1053/j.gastro.2003.11.016 · DOI
  14. Bureau, 2007, Patency of stents covered with polytetrafluoroethylene in patients treated by transjugular intrahepatic portosystemic shunts: long-term results of a randomized multicentre study, Liver Int, 27, 742, 10.1111/j.1478-3231.2007.01522.x · DOI
  15. Perarnau, 2014, Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial, J Hepatol, 60, 962, 10.1016/j.jhep.2014.01.015 · DOI
  16. García-Pagán, 2010, Early use of TIPS in patients with cirrhosis and variceal bleeding, N Engl J Med, 362, 2370, 10.1056/NEJMoa0910102 · DOI
  17. Bureau, 2011, Serum bilirubin and platelet count: a simple predictive model for survival in patients with refractory ascites treated by TIPS, J Hepatol, 54, 901, 10.1016/j.jhep.2010.08.025 · DOI
  18. Salerno, 2007, Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data, Gastroenterology, 133, 825, 10.1053/j.gastro.2007.06.020 · DOI
  19. Allard, 2001, Effects of ascites resolution after successful TIPS on nutrition in cirrhotic patients with refractory ascites, Am J Gastroenterol, 96, 2442, 10.1111/j.1572-0241.2001.04051.x · DOI
  20. Plauth, 2004, Weight gain after transjugular intrahepatic portosystemic shunt is associated with improvement in body composition in malnourished patients with cirrhosis and hypermetabolism, J Hepatol, 40, 228, 10.1016/j.jhep.2003.10.011 · DOI
  21. Montomoli, 2010, Body composition changes after transjugular intrahepatic portosystemic shunt in patients with cirrhosis, World J Gastroenterol, 16, 348, 10.3748/wjg.v16.i3.348 · DOI
  22. Arroyo, 1981, Plasma renin activity and urinary sodium excretion as prognostic indicators in nonazotemic cirrhosis with ascites, Ann Intern Med, 94, 198, 10.7326/0003-4819-94-2-198 · DOI
  23. Sersté, 2010, Deleterious effects of beta-blockers on survival in patients with cirrhosis and refractory ascites, Hepatology, 52, 1017, 10.1002/hep.23775 · DOI
  24. Mandorfer, 2014, Nonselective β blockers increase risk for hepatorenal syndrome and death in patients with cirrhosis and spontaneous bacterial peritonitis, Gastroenterology, 146, 1680, 10.1053/j.gastro.2014.03.005 · DOI
  25. Bellot, 2013, Automated low flow pump system for the treatment of refractory ascites: a multi-center safety and efficacy study, J Hepatol, 58, 922, 10.1016/j.jhep.2012.12.020 · DOI

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Authors
Bureau, C., Thabut, D., Oberti, F., Dharancy, S., Carbonell, N., Bouvier, A., Mathurin, P., Otal, P., Cabarrou, P., Péron, J. M., & Vinel, J. P.
Affiliations
  • Université Toulouse III - Paul Sabatier (FR)
  • Pitié-Salpêtrière Hospital (FR)
  • Centre Hospitalier Universitaire d'Angers (FR)
  • Hôpital Claude Huriez (FR)
  • Hôpital Saint-Antoine (FR)
  • Centre Hospitalier Universitaire de Toulouse (FR)
Corresponding author
Bureau, Christophe
ORCID
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2017-01
Volume
152
Issue
1
Pages
157-163
ISSN
0016-5085 (ISSN-L)
DOI
10.1053/j.gastro.2016.09.016
OpenAlex
W2521555087
Cited by
452
References
0
Citations by year
2026: 26 · 2025: 48 · 2024: 50 · 2023: 49 · 2022: 56 · 2021: 51 · 2020: 50 · 2019: 42 · 2018: 39 · 2017: 36
FWCI
28.93
Type
journal article
Language
en
Update notices
erratum (2017-09-01)
Open access
Licence
Locations
  • Gastroenterology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Keywords
transjugular intrahepatic portosystemic shunt, covered stent, polytetrafluoroethylene stent, liver cirrhosis, recurrent ascites, transplant-free survival, large-volume paracentesis, albumin, portal hypertension, shunt malfunction, encephalopathy, hernia complications, liver transplantation avoidance, Child-Pugh score
MeSH terms
Albumins, Ascites, Female, Hepatic Encephalopathy, Hospitalization, Humans, Hypertension, Portal, Liver Cirrhosis, Male, Middle Aged, Polytetrafluoroethylene, Prospective Studies, Recurrence, Severity of Illness Index, Stents, Survival Rate, Liver Transplantation, Ultrasonography, Doppler, Paracentesis, Portasystemic Shunt, Transjugular Intrahepatic

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