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Current Hepatology Reports

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02.05.2019 | Portal Hypertension (J Gonzalez-Abraldes and E Tsochatzis, Section Editors)

Patient Selection in Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Refractory Ascites and Associated Conditions

verfasst von: Beverley Kok, Juan Gonzalez Abraldes

Erschienen in: Current Hepatology Reports | Ausgabe 2/2019

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Abstract

Purpose of Review

This review summarizes the key developments and latest evidence for transjugular intrahepatic portosystemic shunt (TIPS) for the indications of refractory ascites and related conditions, as well as factors that should be taken into consideration with regard to patient selection.

Recent Findings

Recent evidence from randomized controlled studies has suggested that the early institution of TIPS in well-selected patients with refractory ascites may confer a survival benefit. Increasing evidence is also mounting on the potential role of TIPS in improving and reversing hepatorenal syndrome.

Summary

TIPS has conventionally been sought as a second-line treatment for refractory ascites. Recent evidence has suggested a potential survival benefit with early TIPS in well-compensated patients for this indication; this may lead to a paradigm shift for TIPS to be considered as primary therapy in well-selected “low-risk” patients. In hepatorenal syndrome, while evidence on TIPS is limited, multiple studies have shown a serendipitous improvement to renal function in both type 1 and 2 hepatorenal syndrome following TIPS.

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Titel: Patient Selection in Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Refractory Ascites and Associated Conditions
verfasst von: Beverley Kok
Juan Gonzalez Abraldes
Publikationsdatum: 02.05.2019
Verlag: Springer US
Erschienen in: Current Hepatology Reports / Ausgabe 2/2019
Elektronische ISSN: 2195-9595
DOI: https://doi.org/10.1007/s11901-019-00470-4

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