Response to: Aspirin for patients after TIPS. An old dog with new tricks?

Seifert, Leon Louis; Schindler, Philipp; Bettinger, Dominik; Trebicka, Jonel; Wildgruber, Moritz; Heinzow, Hauke

doi:10.1007/s12072-022-10394-9

Cited by 2 publications

(1 citation statement)

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“…The decision for anticoagulation further depends on the underlying disease, with BCS or PVT certainly requiring anticoagulation [23]. A recent retrospective multicenter study showed a potential survival benefit for acetylsalicylic acid after TIPS in adults [24], although this opinion is not without detractors [25]. In children, there is no consensus, and the primary indication for TIPS may guide anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Children with Transjugular Intrahepatic Portosystemic Shunt: A Meta-Analysis of Individual Patient Data

Deniz

Schinner

Monroe

et al. 2023

Cardiovasc Intervent Radiol

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Purpose The purpose of the study was to investigate outcome after pediatric transjugular intrahepatic portosystemic shunt (TIPS) with respect to survival Material and Methods After searching for studies on TIPS in children in Ovid, Medline, Embase, Scopus and Cochrane published between 2000 and 2022, individual patient data were retrieved from five retrospective cohorts. Overall survival (OS) and transplant-free survival (TFS) were calculated using Kaplan–Meier analysis and log-rank test and compared to the indication (ascites vs. variceal bleeding) as well as to the level of obstruction (pre-hepatic vs. hepatic vs. post-hepatic). Additionally, TIPS patency was analyzed. Results n = 135 pediatric patients were included in the final analysis. Indication for pediatric TIPS creation was heterogeneous among the included studies. TIPS patency decreased from 6 to 24 months, subsequent pediatric liver transplantation was performed in 22/135 (16.3%) of cases. The presence of ascites was related with poorer TFS (HR 2.3, p = 0.023), while variceal bleeding was not associated with impaired survival. Analysis of the level of obstruction (pre-hepatic, hepatic and post-hepatic) failed to prove significantly reduced OS for post-hepatic obstruction (HR 3.2, p = 0.092) and TFS (HR 1.3, p = 0.057). There was no difference in OS and TFS according to age at time of TIPS placement. Conclusions The presence of ascites associates with impaired survival after TIPS in children, with no differences in survival according to the age of the child. Interventional shunt procedures can be considered feasible for all ages. Level of Evidence Level 2a. Graphical Abstract

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Section: Discussionmentioning

confidence: 99%