Introduction: The purpose of this study was to investigate the rates of complications and diagnostic yield of transjugular liver biopsy (TJLB) in deceased donor liver transplant (DDLT) recipients.
Methods: From January 2009 to December 2019, 1,055 TJLBs were performed in 603 adult DDLT recipients with a mean age of 54 (±12 years). Data were retrospectively reviewed to determine the diagnostic efficacy and incidence of major and minor complications in the 3-day and 1-month period after TJLB. In addition, data were stratified according to platelet count and international normalized ratio to determine the safety of TJLB in patients with varying degrees of coagulopathy.
Results: TJLB yielded diagnostic rate of 98.1% (1,035/1,055), with an overall complication rate of 8.3% (88/1,055). Major complications accounted for 0.85% (9/1,055), and minor complications occurred in 7.48% (79/1,055). When patients were stratified by platelet count (0-50, 51-100, 101-200, 201-300, and >300 × 103 platelets/μL), no significant difference was noted in complication rates (9.5%, 8.6%, 7.6%, 8.5%, and 10.7%, respectively). When grouped by international normalized ratio (0-1, 1.1-2.0, 2.1-3.0, and >3.0), there was no statistical difference in complication rates (8.3%, 8.5%, 7.7%, and 0%, respectively).
Discussion: TJLB is a safe, adequate, and effective method to investigate hepatic disorders in DDLT recipients with severe coagulopathy.
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http://dx.doi.org/10.14309/ctg.0000000000000355 | DOI Listing |
J Clin Exp Hepatol
November 2024
Center of Liver and Biliary Sciences, Max Super Speciality Hospital, W-3, Ashok Marg, Sector-1, Vaishali, Ghaziabad, Uttar Pradesh, 2010121, India.
Recipient hepatectomy is considered as the most difficult part of a liver transplant operation. This article describes techniques to deal with scenarios like massive caudate lobe, a recipient with a transjugular intrahepatic portosystemic shunt (TIPS) shunt , a recipient with hepatocellular carcinoma, acute liver failure and a history of previous abdominal surgery.
View Article and Find Full Text PDFJ Clin Exp Hepatol
November 2024
Aster Integrated Liver Care, Aster Medcity, Cheranallur, Kochi 682027, India.
Portal vein thrombosis (PVT) occurs as a part of the natural history of cirrhosis in up to 15% of patients with cirrhosis. In the initial days, PVT was considered a contraindication to liver transplantation, but now with advanced techniques and perioperative management, patients with complex PVT also undergo living-donor liver transplantation (LDLT) with a similar outcome. This review provides a comprehensive overview of methods to proceed with liver transplantation when the recipient has PVT.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Background: Although numerous prognostic scores have been developed for patients with cirrhosis after Transjugular intrahepatic portosystemic shunt (TIPS) placement over years, an accurate machine learning (ML)-based model remains unavailable. The aim of this study was to develop and validate a ML-based prognostic model to predict survival in patients with cirrhosis after TIPS placement.
Methods: In this retrospective study in China, patients diagnosed with cirrhosis after TIPS placement from 2014 to 2020 in our cohort were included to develop a ML-based model.
Sci Rep
January 2025
Department of Interventional Radiology, The First Affiliated Hospital, College of Clinical Medicine of Henan, University of Science and Technology, Jinghua Road #24, Luoyang, 471003, China.
To investigate the association between overt hepatic encephalopathy (OHE) and liver pathology after transjugular intrahepatic portosystemic shunt (TIPS) creation in cirrhotic patients. From July 2015 to April 2024, 73 patients from 4 hospitals in China who received TIPS creation and liver biopsy were retrospectively enrolled in this study. Based on whether OHE occurred within 3 months after TIPS creation, the patients were categorized into OHE (n = 29) and non-OHE (n = 44) groups.
View Article and Find Full Text PDFHepatology
January 2025
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Background Aims: In clinical practice, the reduction of porto-caval pressure gradient (PCPG) following trans-jugular intra-hepatic porto-systemic shunt (TIPS) does not always meet the recommendation of current guidance. We evaluated the impact of different degrees of PCPG reduction, measured at the end of an elective TIPS, on ascites control, recurrence of portal hypertension-related bleeding (PHRB) and survival.
Approach And Results: Cirrhotic patients receiving TIPS for refractory ascites (RA) or for the secondary prophylaxis of PHRB were consecutively enrolled.
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