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Alcohol Recidivism Following Transjugular Intrahepatic Portosystemic Shunt Placement: Frequency and Predictive Factors

  • Clinical Investigation
  • TIPS
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the frequency and predictive factors for alcohol recidivism following transjugular intrahepatic portosystemic shunts (TIPS) placed in patients with alcoholic cirrhosis.

Methods

One hundred ninety-nine patients who had a TIPS placed at a single institution for different indications in the setting of alcoholic cirrhosis were reviewed. Length of sobriety prior to TIPS placement and maintained sobriety at 1, 3 and 6–12 months after TIPS placement were recorded. Smoking history, substance abuse and psychiatric comorbidities were also recorded as was ascitic response to TIPS at 1, 3 and 6–12 months.

Results

At 1 month 11/199 (5.5%) patients had experienced a relapse while, 20/199 (10.1%) had at 3 months, and 44/199 (22.1%) had at 12 months. There was no difference in ascitic response in those who did and did not relapse at 1 month (p = 0.57), 3 months (p = 1.00) or 1 year (p = 0.44). The mean time of sobriety at the time of TIPS placement for those who relapsed by 12 months was significantly less than those who did not relapse (5.11 (1.10–7.90) months vs 18.32 (8.63–48.12) months, p < 0.001). Concurrent psychiatric comorbidity (p < 0.001), substance abuse (p < 0.001), age less than 40 (p = 0.004) and smoking history at the time of procedure (p < 0.001) were also associated with alcohol relapse.

Conclusion

Recidivism is a frequent issue for patients following TIPS placement; those who have concurrent psychiatric comorbidity, substance abuse, smoking history are younger than 40 and shorter sobriety duration prior to TIPS may be at increased risk.

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Abbreviations

ALD:

Alcohol-related liver disease

BMI:

Body mass index

CPS:

Child–Pugh score

LT:

Liver transplantation

MELD:

Model for End-Stage Liver Disease

MELD-Na:

Model for End-stage Liver Disease-Sodium

PSG:

Post-procedural portosystemic gradient

TIPS:

Transjugular intrahepatic portosystemic shunts

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Author notes

  1. Shamar Young

    Present address: Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN, 55455, USA

Authors and Affiliations

  1. Department of Radiology, Division of Interventional Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN, 55455, USA

    Isa Cam, Sandeep Sharma, Jason Wong, Mary Yang, Jafar Golzarian & Siobhan Flanagan

  2. Department of Radiology, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN, 55455, USA

    Mehmet Gencturk

  3. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, 420 Delaware ST SE, Minneapolis, MN, 55455, USA

    Nicholas Lim

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  1. Isa Cam
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Correspondence to Shamar Young.

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Consent for publication was obtained for the person’s data included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This study has obtained IRB approval from the University of Minnesota, and the need for informed consent was waived.

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Cam, I., Gencturk, M., Lim, N. et al. Alcohol Recidivism Following Transjugular Intrahepatic Portosystemic Shunt Placement: Frequency and Predictive Factors. Cardiovasc Intervent Radiol 44, 758–765 (2021). https://doi.org/10.1007/s00270-020-02754-5

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  • DOI: https://doi.org/10.1007/s00270-020-02754-5

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