Impact of transjugular intrahepatic porto-systemic shunt on post liver transplantation outcomes: Study based on the United Network for Organ Sharing database

Table 1 Demographics and clinical variables categorized by transjugular intrahepatic porto-systemic shunt status

Variables	TIPS on waitlist (n = 1366; % or mean ± SD)	Non TIPS on waitlist (n = 31417; % or mean ± SD)	P-values
Male candidate	943 (69)	21374 (68)	0.43
Candidate race			< 0.001
White	1072 (78.4)	23063 (73.4)
Black	75 (5.4)	2865 (9.1)
Other	219 (16)	5489 (17.4)
Diabetes mellitus	380 (28)	7769 (24.8)	0.009
ALD	311 (22.7)	6615 (21)	0.13
Hepatic encephalopathy			0.01
None	373 (27.3)	8409 (26.7)
Grade 1-2	925 (67.7)	20790 (66.1)
Grade 3-4	68 (4.9)	2218 (7)
Arterial hypertension	68 (14.8)	2254 (19.7)	0.01
Age	53.5 ± 8.5	53.6 ± 9.3	0.65
MELD score at listing	16.6 ± 6.6	19.66 ± 8.8	< 0.001
Creatinine	1.2 ± 0.8	1.4 ± 1.2	< 0.001
Bilirubin	4.1 ± 6.3	6.61 ± 9.0	< 0.001
INR	1.5 ± 0.4	1.7 ± 0.8	< 0.001
Albumin	2.9 ± 0.6	2.9 ± 0.6	0.66
BMI at list entry
Continuous (kg/m2)	28.8 ± 5.6	28.8 ± 5.7	0.89
Dichotomous (≥ 26 kg/m2)	905 (66.4)	20747 (66.2)	0.85
Cold ischemia time
Continuous (h)	7.1 ± 3.7	6.9 ± 3.5	0.03
Dichotomous (> 12 h)	66 (5.0)	1360 (4.5)	0.38
MELD score at transplantation	23.1 ± 9.1	22.6 ± 9.7	0.03

TIPS: Transjugular intrahepatic porto-systemic shunt; ALD: Alcoholic liver disease; MELD: Model for end-stage liver disease; INR: International normalized ratio; BMI: Body mass index.

Table 2 Comparison of various outcomes on univariate analysis on waitlist and post liver transplant

	TIPS on waitlist (n = 1366) % or mean ± SD	No TIPS on waitlist (n = 31417) % or mean ± SD	P-values
Days on LT waitlist	408 ± 552.6	183 ± 330.5	< 0.001
Mortality within 30 d	46 (3.5)	915 (3.0)	0.344
Length of hospital stay	17.58 ± 22.4	16.62 ± 22.1	0.118
Re-LT at 30 d	15 (1.1)	560 (1.8)	0.06

TIPS: Transjugular intrahepatic porto-systemic shunt; LT: Liver transplantation.

Table 3 Multivariable logistic regression analysis to assess the impact of transjugular intrahepatic porto-systemic shunt on 30-d mortality after liver transplant

Variable	OR (95%CI)	P-values
TIPS	1.26 (0.90-1.75)	0.17
Male candidate	0.83 (0.71-0.95)	0.01
Candidate race
White	Ref.
Black	1.08 (0.85-1.37)	0.54
Other	1.08 (0.90-1.29)	0.40
Diabetes mellitus	1.12 (0.95-1.31)	0.17
ALD	0.89 (0.74-1.07)	0.22
Hepatic encephalopathy
None	Ref.
Grade 1-2	0.86 (0.73-1.01)	0.06
Grade 3-4	1.12 (0.85-1.47)	0.41
Age	1.02 (1.01-1.03)	< 0.001
MELD score	1.02 (1.00-1.04)	0.05
Creatinine	1.03 (0.97-1.10)	0.33
Bilirubin	1.01 (1.00-1.02)	0.008
INR	0.97 (0.86-1.09)	0.59
Albumin	0.88 (0.79-0.98)	0.03
BMI	1.00 (0.99-1.02)	0.86
Cold ischemia time	1.04 (1.02-1.05)	< 0.001

TIPS: Transjugular intrahepatic porto-systemic shunt; ALD: Alcoholic liver disease; MELD: Model for end-stage liver disease; INR: International normalized ratio; BMI: Body mass index.

Table 4 Multivariable logistic regression analysis to assess the impact of transjugular intrahepatic porto-systemic shunt on retransplantation

Variable	OR (95%CI)	P-values
TIPS	0.61 (0.36-1.05)	0.07
Male candidate	1.02 (0.85-1.24)	0.81
Candidate race
White	Ref.
Black	1.22 (0.91-1.64)	0.18
Other	1.05 (0.83-1.32)	0.69
Diabetes mellitus	0.98 (0.78-1.21)	0.83
ALD	0.98 (0.78-1.24)	0.90
Hepatic encephalopathy
None	Ref.
Grade 1-2	0.92 (0.76-1.13)	0.44
Grade 3-4	1.02 (0.69-1.51)	0.91
Age	0.97 (0.96-0.98)	< 0.001
MELD score	0.99 (0.97-1.02)	0.51
Creatinine	0.87 (0.77-0.99)	0.03
Bilirubin	0.99 (0.98-1.02)	0.54
INR	1.01 (0.86-1.18)	0.9
Albumin	1.03 (0.89-1.19)	0.65
BMI	1.005 (0.98-1.02)	0.54
Cold ischemia time	1.05 (1.03-1.07)	< 0.001

TIPS: Transjugular intrahepatic porto-systemic shunt; ALD: Alcoholic liver disease; MELD: Model for end-stage liver disease; INR: International normalized ratio; BMI: Body mass index.

Table 5 Ordinary least squares regression to assess the impact of transjugular intrahepatic porto-systemic shunt on length of hospital stay after liver transplant

Variable	β (95%CI)	P-values
TIPS	2.16 (0.92-3.38)	0.001
Male candidate	-1.99 (-2.52-1.46)	< 0.001
Candidate race
White	Ref.
Black	-1.58 (-2.46-0.69)	< 0.001
Other	0.11 (-0.53-0.77)	0.72
Diabetes mellitus	0.52 (-0.05-1.10)	0.07
ALD	0.17 (-0.44-0.79)	0.57
Hepatic encephalopathy
None	Ref.
Grade 1-2	-0.10 (-0.66-0.46)	0.73
Grade 3-4	3.46 (2.37-4.55)	< 0.001
Age	0.09 (0.06-0.11)	< 0.001
MELD score	0.37 (0.31-0.44)	< 0.001
Creatinine	0.05 (-0.21-0.31)	0.71
Bilirubin	0.03 (-0.008-0.08)	0.1
INR	-1.06 (-1.50-0.61)	< 0.001
Albumin	-0.63 (-1.01-0.24)	0.001
BMI	-0.05 (-0.100-0.01)	0.01
Cold ischemia time	0.36 (0.29-0.43)	< 0.001
Constant	7.83 (5.38-10.27)	< 0.001

TIPS: Transjugular intrahepatic porto-systemic shunt; ALD: Alcoholic liver disease; MELD: Model for end-stage liver disease; INR: International normalized ratio; BMI: Body mass index.