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Updated: Jun 18, 2026
12:27
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Liver Transplant Outcomes in Patients With Transjugular Intrahepatic Portosystemic Shunt: A Retrospective Cohort
Marco Biolato1,2, Quirino Lai3,4, Tiziano Galasso1
1Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Journal of Clinical and Experimental Hepatology
|June 17, 2026
Summary
Pretransplant transjugular intrahepatic portosystemic shunt (TIPS) placement did not increase postoperative complications or mortality in liver transplant recipients. However, higher reoperation rates suggest careful patient selection is needed.
Area of Science:
- Hepatology
- Transplantation Surgery
- Interventional Radiology
Background:
- Transjugular intrahepatic portosystemic shunt (TIPS) is utilized for managing portal hypertension complications in liver transplant candidates.
- The precise impact of pretransplant TIPS on liver transplantation outcomes remains a subject of debate.
Purpose of the Study:
- To investigate the effect of pretransplant TIPS on postoperative complications and in-hospital mortality following liver transplantation.
- To evaluate the association between pretransplant TIPS and surgical outcomes in cirrhotic patients.
Main Methods:
- Retrospective, single-center cohort study including 263 cirrhotic patients undergoing liver transplantation from deceased donors (2015-2023).
- Analysis of 23 patients (8.7%) who received pretransplant TIPS using controlled-expansion stents.
- Propensity score weighting was applied to compare outcomes between patients with and without pretransplant TIPS.
Main Results:
- Pretransplant TIPS was not independently linked to operative time, bypass use, transfusion needs, ICU/hospital stay, or overall complication rates.
- A significantly higher reoperation rate was observed in the pretransplant TIPS group (17.4% vs. 8.0%, P=0.003).
- Previous abdominal surgery was identified as the sole independent predictor of in-hospital mortality.
Conclusions:
- Pretransplant TIPS may enable comparable postoperative outcomes for patients with severe portal hypertension, but without a clear survival advantage.
- The use of pretransplant TIPS should be restricted to cases meeting established guideline indications due to the absence of proven survival benefits.
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