4:12 PM Abstract No. 325 Transjugular intrahepatic portosystemic shunt improves liver function in patients with alcohol-induced cirrhosis

Abstract

The primary objective of this study was to assess liver function post TIPS using ALBI and MELD scores, and to compare with case matched patients who did not undergo TIPS. A secondary objective of this study was to assess for liver function deterioration in the two groups based on disease etiology. 40 consecutive patients undergoing TIPS due to complications from cirrhosis between 2012-2019 were included in this study. These patients were matched with 40 patients with cirrhosis who did not undergo the TIPS procedure. Patients were matched using propensity score matching using the following parameters: (1) baseline ALBI score, (2) baseline MELD score, (3) cirrhosis etiology, (4) age, (5) gender, and (6) presence or absence of HCC. MELD and ALBI scores were measured at 1, 3-6 and 12 months post TIPS. Subgroup analysis was performed based on disease etiology. Statistical analysis was performed using Excel (Microsoft, Redmond, WA). The median ALBI scores for the TIPS cohort at baseline, 1, 3-6 and 12 months were: -1.33, -1.37, -1.6, -1.39. These values were -1.34, -1.38, -1.71, -1.9 for the non-TIPS cohort. The median MELD scores for the TIPS cohort at baseline, 1, 3-6 and 12 months post TIPS were: 14, 16, 15 and 17. These values were 17, 17, 19, and 18 for the non-TIPS cohort. Subgroup analysis was performed for patients with HCV and EtOH induced cirrhosis, as they both had large enough paired samples for analysis. In 12 patients with HCV, patients post TIPS had comparatively worsened hepatic function between each time point compared to non-TIPS controls. The relative increase in MELD and ALBI score between matched Hepatitis C TIPS versus non-TIPS at 1, 3-6 and 12 months were: 0.8, 1.3, 4.2 (MELD), and 0.3, 0.5, 1.1 (ALBI). In 12 patients with EtOH cirrhosis, patients post TIPS had comparatively improved function between each time point compared to non-TIPS controls. The relative decrease in MELD and ALBI between matched EtOH TIPS versus non-TIPS at 1, 3-6 and 12 months were: 0.8, 2.2, 1.2 (MELD) and 0.15, 0.21, 0.35 (ALBI). Liver function deterioration after TIPS may be dependent on etiology of underlying liver disease. Further studies are needed to validate our findings.