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Is 70 the new 50? Complications and outcomes of transjugular intrahepatic portosystemic shunt in older versus younger patients

  • Special Section : Liver Transplantation
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Background

An increased risk of complications of TIPS in patients older than 65 years of age has been described, but data is limited. The objective of this study was to determine if the rate of complications post-TIPS differs in patients 65 or younger, compared to those older than 65 years of age.

Methods

A retrospective chart review was performed for all patients who underwent TIPS procedure at Banner—University Medical Center Phoenix, from 2010 to 2018, specifically focusing on complications and outcomes post-TIPS. In total, 402 patients were included in this analysis. Complications included portosystemic encephalopathy, post-TIPS infection, acute kidney injury requiring hemodialysis, hemorrhage, respiratory complications, need for transplant, or death.

Results

A total of 402 patients were included and divided into two groups: 300 (74.6%) were 65 years or younger (ages 53 ± 9), and 102 were older than 65 years (70 ± 5 (p < 0.001)). There were no statistically significant differences between age groups when comparing portosystemic encephalopathy, post-TIPS infection, acute kidney injury, respiratory complications, need for transplant, or death.

Conclusion

In this large, single-center cohort, there was no statistically significant difference in the rate of complications of TIPS between the two age groups. Based on our results, TIPS procedure is an equally safe option for properly selected patients with complications of portal hypertension, regardless of age.

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Acknowledgements

The authors are in debt to the Interventional Radiology team at BUMCP, who performed the TIPS procedure during the years of the study: Drs. Kevin Hirsh, David Wood, Steven Chen and Cole Mendenhall.

Funding

Ester C. Little MD has a research grant on NAFLD from Intercept Pharmaceutical. Mark N. Wong MD is a speaker for AppVie Inc. for Hepatitis C and a speaker for Gilead Sciences for Hepatitis B. There are no disclosures from any other author.

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Authors and Affiliations

  1. University of Arizona College of Medicine – Phoenix, 475 N. 5th St., Phoenix, AZ, 85004, USA

    Roy U. Bisht, Margaret C. Liu & Jenna E. Koblinski

  2. Mel and Enid Zuckerman College of Public Health, 550 E. Van Buren St., Phoenix, AZ, 85006, USA

    Paul Kang

  3. Banner Advanced Liver Disease and Transplant Institute, Banner University Medical Center – Phoenix, 1441 N. 12th St., Phoenix, AZ, 85006, USA

    Mark N. Wong & Ester C. Little

  4. Department of Internal Medicine, University of Arizona College of Medicine – Phoenix, 475 N. 5th St., Phoenix, AZ, USA

    Mark N. Wong & Ester C. Little

Authors
  1. Roy U. Bisht
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  2. Margaret C. Liu
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  3. Jenna E. Koblinski
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  4. Paul Kang
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  6. Ester C. Little
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Correspondence to Ester C. Little.

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Bisht, R.U., Liu, M.C., Koblinski, J.E. et al. Is 70 the new 50? Complications and outcomes of transjugular intrahepatic portosystemic shunt in older versus younger patients. Abdom Radiol 46, 2789–2794 (2021). https://doi.org/10.1007/s00261-020-02533-3

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  • DOI: https://doi.org/10.1007/s00261-020-02533-3

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