Vidal-González, J;
Martínez, J;
Mulay, A;
López, M;
Baiges, A;
Elmahdy, A;
Lampichler, K;
... Genescà, J; + view all
(2024)
Evolution of spontaneous portosystemic shunts over time and following aetiological intervention in patients with cirrhosis.
JHEP Reports
, 6
(2)
, Article 100977. 10.1016/j.jhepr.2023.100977.
Preview |
PDF
1-s2.0-S2589555923003087-main.pdf - Published Version Download (706kB) | Preview |
Abstract
BACKGROUND & AIMS: Spontaneous portosystemic shunts (SPSS) develop frequently in cirrhosis. Changes over time and the effect of aetiological interventions on SPSS are unknown, so we aimed to explore the effect of these variables on SPSS evolution. METHODS: Patients with cirrhosis from the Baveno VI-SPSS cohort were selected provided a follow-up abdominal CT or MRI scan was available. Clinical and laboratory data were collected at baseline and follow-up. Imaging tests were reviewed to evaluate changes in the presence and size of SPSS (large (L)-SPSS was ≥8 mm) over time. Regarding alcohol- or HCV-related cirrhosis, two populations were defined: cured patients (abstinent from alcohol or successful HCV therapy), and non-cured patients. RESULTS: A total of 617 patients were included. At baseline SPSS distribution was 22% L-SPSS, 30% small (S)-SPSS, and 48% without (W)-SPSS. During follow-up (median follow-up of 63 months), SPSS distribution worsened: L-SPSS 26%, S-SPSS 32%, and W-SPSS 42% (p <0.001). Patients with worse liver function during follow-up showed a simultaneous aggravation in SPSS distribution. Non-cured patients (n = 191) experienced a significant worsening in liver function, more episodes of liver decompensation and lower transplant-free survival compared to cured patients (n = 191). However, no differences were observed regarding SPSS distribution at inclusion and at follow-up, with both groups showing a trend to worsening. Total shunt diameter increased more in non-cured (52%) than in cured patients (28%). However, total shunt area (TSA) significantly increased only in non-cured patients (74 to 122 mm2, p <0.001). CONCLUSIONS: The presence of SPSS in cirrhosis increases over time and parallels liver function deterioration. Aetiological intervention in these patients reduces liver-related complications, but SPSS persist although progression is decreased.
| Type: | Article |
|---|---|
| Title: | Evolution of spontaneous portosystemic shunts over time and following aetiological intervention in patients with cirrhosis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jhepr.2023.100977 |
| Publisher version: | https://doi.org/10.1016/j.jhepr.2023.100977 |
| Language: | English |
| Additional information: | © 2023 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL) Under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10186138 |
Archive Staff Only
 |
View Item |
