Consequences of TIPSS placement on the body composition of patients with cirrhosis and severe portal hypertension: a large retrospective CT-based surveillance.

Details

Serval ID
serval:BIB_7153006202F0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Consequences of TIPSS placement on the body composition of patients with cirrhosis and severe portal hypertension: a large retrospective CT-based surveillance.
Journal
Alimentary pharmacology & therapeutics
Author(s)
Artru F., Miquet X., Azahaf M., Labreuche J., Ntandja Wandji L.C., Sergent G., Nobécourt A., Toumelin P., Lassailly G., Dharancy S., Ernst O., Mathurin P., Louvet A.
ISSN
1365-2036 (Electronic)
ISSN-L
0269-2813
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Body composition may be modified after improvement of portal hypertension (PHT) by transjugular intrahepatic portosystemic shunt (TIPSS) insertion.
To evaluate changes in body composition following TIPSS placement, their relationship with radiological TIPSS patency and function, and the predictive value of these parameters METHODS: We retrospectively included 179 patients with cirrhosis who underwent TIPSS placement in our centre for severe PHT from 2011 to 2017. CT scan-based surveillance was performed at baseline, 1-3 (M1-M3) and 6 months (M6).
The median model for end-stage liver disease (MELD) score was 11.4 (8.8-15.1) and Child-Pugh score 8 (7-9). Only the MELD score (HR 1.14, 95% CI 1.08-1.20) and sarcopenia assessed by transversal right psoas muscle thickness at the umbilical level/height (TPMPT/height) (HR 0.86, 95% CI 0.79-0.96) were independently associated with a 6-month mortality on multivariate analysis. After TIPSS insertion, TPMT/height increased from 19 mm/m (baseline) to 19.6 mm/m (M1-M3, P = 0.004) and 21.1 mm/m (M6, P < 0.0001). The improvement and its extent were dependent on the radiological patency and dysfunction of TIPSS. Subcutaneous fat surface (SCFS) increased from 183.4 to 193 cm <sup>2</sup> (P < 0.0001) and 229.8 cm <sup>2</sup> (P < 0.0001), respectively. We observed a decrease in visceral fat surface (VFS) between baseline and M1-M3 (163.5-140.5 cm <sup>2</sup> [P < 0.0001]), but not between M1-M3 and M6 (140.5-141.2 cm <sup>2</sup> [P = 0.9]). SCFS and VFS did not seem to be modified by radiological TIPSS patency and dysfunction.
Sarcopenia is independently associated with 6-month outcome and improves after TIPSS placement, together with an inverse evolution of subcutaneous and visceral fat. TIPSS not only treats portal hypertension but also improves body composition.
Pubmed
Create date
19/09/2020 12:01
Last modification date
14/10/2020 5:26
Usage data