سامانه کنگره های دانشگاه علوم پزشکی و خدمات بهداشتی و درمانی آذربایجان غربی

صفحه اصلی / بیستمین همایش سالیانه بیماری های شایع گوارش و کبد کودکان ایران و دومین همایش بین المللی چاقی کودکان

The Efficacy and Safety of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Pediatric Portal Hypertension: A Meta-Analysis of Individual Patient Data

نویسندگان :

Roghayeh Faraji Akhijahani¹ Aydin Mahmoud Alilou² Parinaz Mahmoud Alilou³ Amir Reza Bana Nasli⁴ Amir Hossein Eskandari⁵ Asal Khaksar Kolvanagh⁶ Pouria Shieeh⁷ Alisan Khodayarlo⁸ Sina Manouchehrnia⁹ Sana Nasirpour¹⁰ Meysam Najafi¹¹ Reza Rostami¹² Pardis Pour Ali¹³

1- دانشگاه علوم پزشکی تبریز 2- دانشگاه علوم پزشکی تبریز 3- دانشگاه علوم پزشکی تبریز 4- دانشگاه علوم پزشکی تبریز 5- دانشگاه علوم پزشکی تبریز 6- دانشگاه علوم پزشکی تبریز 7- دانشگاه علوم پزشکی تبریز 8- دانشگاه علوم پزشکی تبریز 9- دانشگاه علوم پزشکی تبریز 10- دانشگاه علوم پزشکی تبریز 11- دانشگاه علوم پزشکی تبریز 12- دانشگاه علوم پزشکی تبریز 13- دانشگاه علوم پزشکی تبریز

کلمات کلیدی :

Pediatric portal hypertension،Transjugular intrahepatic portosystemic shunt،Shunt patency،Survival analysis،Post-hepatic obstruction

چکیده :

Background and Aim: Portal hypertension in children poses significant clinical challenges due to its diverse etiology and limited evidence-based interventions. Transjugular intrahepatic portosystemic shunt (TIPS) is a minimally invasive procedure increasingly used in pediatric populations, yet its long-term efficacy and safety remain understudied. This meta-analysis aims to evaluate outcomes of TIPS in children, focusing on survival, shunt patency, and complications. Methods: Individual patient data from 15 international cohorts (2010–2023) were analyzed. Inclusion criteria encompassed children aged 1–18 years undergoing TIPS for portal hypertension. Primary outcomes included overall survival (OS), transplant-free survival (TFS), and shunt patency. Secondary outcomes comprised procedural complications and predictors of adverse events. Results: Among 220 patients, OS at 1, 3, and 5 years was 89%, 76%, and 68%, respectively. TFS rates were 82% (1 year) and 63% (5 years). Shunt patency declined from 78% at 6 months to 52% at 24 months. Major complications included hepatic encephalopathy (12%) and shunt thrombosis (8%). Ascites and post-hepatic obstruction were independent predictors of reduced TFS (HR = 2.1, p = 0.01). Conclusion: TIPS is a viable intervention for pediatric portal hypertension, though long-term patency remains suboptimal. Ascites and post-hepatic etiologies correlate with poorer outcomes, necessitating tailored follow-up protocols.