Transjugular intrahepatic porto-systemic shunt in the elderly: Palliation for complications of portal hypertension

Table 1 Patient characteristics and clinical results

Patient	Sex, age (yr)	Underlying condition	Indication for TIPS	Previous treatment	Child pugh score	MELD score	Survival post shunt	Complications and follow-up
1	F (76)	Hepatitis B	Hydrothorax, refractory ascites	Numerous thoracenteses, furosemide	B (9)	9	25 mo, expired	transient encephalopathy (grade 1 to 2) 1 episode < 30 d, 6 episodes over 24 mo, pulm, edema x 1
2	M (78)	Celiac sprue	Refractory ascites	Numerous paracenteses, spironolactone	C (10)	7	41 mo, expired	Encephalopathy (grade 1 to 2) > 30 d 6 episodes over 40 mo
3	M (71)	Cryptogenic cirrhosis	Refractory ascites	Numerous paracenteses, spironolactone	B (8)	16	8 mo, expired	None
4	F (80)	Cryptogenic cirrhosis	Hepatic hydrothorax	Numerous thoracenteses, spironolactone	C (11)	11	3.5 mo, expired	Encephalopathy transient grade 1 (2 episodes at 30 d and 3 mo)
5	M (69)	Sclerosing cholangitis	Refractory ascites	Numerous paracenteses, spironolactone	C (12)	17	3 mo, expired post attempted shunt	None
6	M (65)	Alcoholic cirrhosis	Hepatic hydrothorax	Numerous thoracenteses, spironolactone, lasix	B (9)	15	19 mo liver transplant, still alive	Encephalopathy transient grade 1 (1 episode > 30 d and < 3 mo)
7	M (71)	Alcoholic cirrhosis	Refractory ascites	Numerous paracenteses, spironolactone, lasix	C (10)	13	3 mo, expired	Encephalopathy transient grade 1 (3 episodes > 30 d)
8	F (70)	Hepatitis C	Refractory ascites, skin breakdown	Numerous paracenteses, spironolactone, lasix	B (8)	9	2nd TIPS placed at 21 mo due to occlusion of 1st TIPS expired 47 mo post initial TIPS	None
9	F (66)	Hepatitis C	Acute bleeding		B (7)	9	Lost to fu pt in Spain	None
10	F (72)	Cryptogenic	Acute bleeding, refractory ascites	Paracentesis, propanolol, lactulose, protonix	B (9)	12	10 mo lost to fu	None
11	F (72)	Hepatitis C	Acute bleeding	Sclerotherapy, spleno-renal shunt × 2, numerous paracentesis, lasix, spironolactone	B (8)	9	Liver transplant 18 mo after TIPS, still alive	None
12	F (67)	Hepatitis B portal vein thrombois	Acute bleeding	Octreotide, protonix	C (10)	10	Liver transplant 16 mo after TIPS, still alive	None
13	M (74)	Hepatitis C (end stage liver disease)	Refractory ascites	Aldactone, lasix, lactulose, protonix	B (8)	15	2 wk, expired	Transient encephalopathy grade 1 (< 2 wk)
14	F (68)	Hepatitis C	Acute bleeding	Midodrine	B (7)	24	2 mo, expired	Recurrent GI bleed 3 wk required revision
15	M (69)	Cryptogenic	Acute bleeding	4 unsuccessful banding, lasix, spironolactone, lactulose, paracentesis	C (10)	21	Revision required 48 h after liver transplant 11 mo after revision, still alive	Continued bleed after 1st TIPS, stopped after revision
16	F (73)	NASH cirrhosis	Acute bleeding	Octreotide, protonix, spironolactone, lasix	B (9)	11	25 mo, still alive	Minimal ascites
17	M (71)	Cryptogenic	Acute bleeding	Band ligation-not successful	B (8)	16	Lost to fu	None
18	M (82)	Cryptogenic	Refractory ascites, acute bleeding	Numerous paracentesis, lasix, amiloride	B (9)	16	2 wk expired (AV block-DNR/DNI )	None
19	M (73)	Hepatitis C	Refractory ascites	Numerous paracenteses, Spironolactone, lasix s/p kidney and liver tx	B (9)	14	1 mo lost to fu	None
20	F (78)	Hepatitis C	Acute bleeding, refractory ascites		B (8)	18	5 d, expired	Post-procedural bleeding, encephalopathy (< 30 d), ascites
21	M (71)	Cirrhosis	Acute bleeding		B (8)	11	Status unknown, discharged to rehabilitation hospital	None
22	M (66)	Alcoholic cirrhosis, s/p liver transplant, portal vein thrombosis	Refractory ascites	Lasix	B (9)	8	Unknown	Failed attempted TIPS
23	M (76)	Alcoholic cirrhosis	Refractory ascites	Numerous paracenteses (once a week)	B(8)	12	15 mo, still alive	None