Dynamic changes in liver function after transjugular intrahepatic portosystemic shunt in patients with cirrhosis

Purpose

To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with cirrhosis and to explore its association with clinical outcomes.

Methods

This retrospective study included patients who underwent TIPS between August 2016 and December 2020. Liver function was primarily evaluated using the model for end-stage liver disease (MELD) score, which was analyzed at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months using one-way repeated measures ANOVA. The Kaplan-Meier method, log-rank test, and multivariate analysis were used as appropriate.

Results

In total, 235 patients were included in this study. The MELD score was significantly higher at 1 week (11.8 ​± ​3.1 vs 13.5 ​± ​3.5, p ​< ​0.05) and 1 month (11.8 ​± ​3.1 vs 13.2 ​± ​4.6, p ​< ​0.05) than the baseline level and recovered at 3 months (11.8 ​± ​3.1 vs 11.9 ​± ​3.9, p ​> ​0.05). At 12 months, the MELD score was higher than the baseline level (11.8 ​± ​3.1 vs 12.4 ​± ​3.2, p ​< ​0.05). Patients with a recovery of the MELD score (n ​= ​151) at 3 months had a lower probability of overt and severe HE (log-rank p ​= ​0.015 and p ​= ​0.027, respectively) than those without recovery (n ​= ​84). Logistic regression analysis revealed that albumin (odds ratio [OR], 0.926; 95% confidence interval [CI], 0.863–0.992; p ​= ​0.029) and platelet count (OR, 0.993; 95% CI, 0.987–0.999; p ​= ​0.033) were independent predictive factors for non-recovery of the MELD score at 3 months.

Conclusions

Liver function after TIPS creation showed a trend of deterioration at first, followed by recovery. Recovery of liver function at three months was associated with reduced overt and severe HE.