ObjectiveTo compare the survival prognosis of the transjugular intrahepatic portosystemic shunt(TIPS) in the treatment of pyrrolizidine alkaloids-induced hepatic sinusoidal obstruction syndrome(PA-HSOS) and decompensated cirrhose-related refractory ascites.
MethodsThe clinical data of 141 patients with PA-HSOS and 42 patients with decompensated cirrhose-related refractory ascites were retrospective analyzed.The survival rates in two groups after TIPS were calculated using the Kaplan-Meier analysis, and the results of which was compared using log-rank test.The propensity score matching(PSM) was used, the caliper value was set to 0.2.The age, end-stage model of liver disease(MELD) score, preoperative dominant hepatic encephalopathy, preoperative portal venous thrombosis and portal venous blood flow velocity were matched by 1:1.
ResultsThe median survival time in all cases was 16.57 months.The preoperative Child-Pugh grade and MELD score in PA-HSOS patients were higher than those in decompensated cirrhosis patients(P < 0.01).There was no statistical significance in the survival time after TIPS between two groups16.63 (10.67-26.60) months vs 16.47 (9.40-41.53) months (P>0.05).After propensity score matching, 24 cases with PA-HSOS were successfully matched with 24 cases with decompensated cirrhosis.The survival time of PA-HSOS patients was longer than that of decompensated cirrhosis patients15.17(10.27-27.03) months vs 13.75(10.67-21.07) months (P < 0.01).
ConclusionsThe TIPS can treat the PA-HSOS or decompensated cirrhose-related refractory ascites.Although the former has poorer preoperative liver function and portal hemodynamics, the PA-HSOS patients do not have worse postoperative survival compared with the decompensated cirrhose-related refractory ascites patients.
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