Predictive factors for improvement of ascites after transjugular intrahepatic portosystemic shunt in patients with refractory ascites.

Abstract

AIM:

The aim of this study was to investigate the predictive factors for the response of ascites to a transjugular intrahepatic portosystemic shunt (TIPS) and the impact of improvement of ascites on the overall prognosis of patients with cirrhosis and refractory ascites.

METHODS:

Forty-seven consecutive patients with liver cirrhosis who underwent TIPS for refractory ascites were studied retrospectively. The mean follow-up period was 615 ± 566 days.

RESULTS:

Thirty-six of the patients (77%) were responders at 4 weeks after TIPS (early responders) and 37 (79%) were responders at 8 weeks after TIPS. Of the 11 non-responders at 4 weeks, four showed an improvement of ascites at 8 weeks. Multivariate analysis showed that only the serum creatinine level before TIPS was an independent predictor of an early response. The cumulative survival rate of early responders was significantly higher than that of non-responders. The survival of patients grouped according to creatinine level was better in patients with serum creatinine of 1.9 mg/dL or less than in those with serum creatinine of more than 1.9 mg/dL.

CONCLUSION:

A low serum creatinine level in patients with refractory ascites is associated with an early response to TIPS. An early response of ascites to TIPS provides better survival. A serum creatinine level below 1.9 mg/dL is required for a good response to TIPS.

• Authors: Yasuhiko Taki, Hidenori Kanazawa, Yoshiyuki Narahara, Norio Itokawa, Chisa Kondo, Takeshi Fukuda, Hirotomo Harimto, Yoko Matsushita, Hideko Kidokoro, Tamaki Katakura, Masanori Atsukawa, Yuu Kimura, Katsuhisa Nakatsuka, Choitsu Sakamoto
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 44 Issue 8 Pg. 871-7 (Aug 2014) ISSN: 1386-6346 [Print] Netherlands
• PMID: 23819607 (Publication Type: Journal Article)
• Copyright: © 2013 The Japan Society of Hepatology.