Pre-emptive TIPS should be considered in high-risk patients with both acute variceal bleeding and severe alcohol-related hepatitis
Severe alcohol-related hepatitis and acute variceal bleeding may occur concomitantly, yet the role of pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS) placement in this setting remains unclear. In this study, compared to standard of care, pTIPS treatment was associated with lower mortality, although this difference did not reach statistical significance, as well as a significantly reduced risk of rebleeding and recurrent ascites. These findings suggest that severe alcohol-related hepatitis should not be viewed as a contraindication to pTIPS placement when otherwise indicated, such as in patients with Child-Pugh B cirrhosis with a score greater than 7 and active bleeding, or Child-Pugh C10-13 disease.
Authors
- Marie‐Angèle Robic (ORCID: https://orcid.org/0000-0002-9540-2322)
- Mattias Mandorfer (ORCID: https://orcid.org/0000-0003-2330-0017)
- Juan Carlos García‐Pagán (ORCID: https://orcid.org/0000-0001-9032-4954)
- Dominique Thabut (ORCID: https://orcid.org/0000-0002-9658-0323)
- Susana Rodrigues (ORCID: https://orcid.org/0000-0002-3261-2795)
- Bogdan Procopeț (ORCID: https://orcid.org/0000-0001-8118-1760)
- Meritxell Ventura‐Cots (ORCID: https://orcid.org/0000-0001-9513-2855)
- Marco Senzolo (ORCID: https://orcid.org/0000-0002-7261-6520)
- Anna Baiges (ORCID: https://orcid.org/0000-0002-6963-9203)
- Lukas Hartl (ORCID: https://orcid.org/0000-0003-3398-6120)
- Alexander Zipprich (ORCID: https://orcid.org/0000-0001-8403-7983)
- Philippe Sultanik
- Fanny Turón (ORCID: https://orcid.org/0000-0001-5940-2838)
- Charlotte Bouzbib
- Agustı́n Albillos (ORCID: https://orcid.org/0000-0001-9131-2592)
- Michael Praktiknjo (ORCID: https://orcid.org/0000-0001-7033-9956)
- Joan Genescà (ORCID: https://orcid.org/0000-0002-0831-8422)
- Virginia Hernández Gea
- Hélène Larrue (ORCID: https://orcid.org/0000-0003-3216-7692)
- Wim Laleman (ORCID: https://orcid.org/0000-0002-0842-7813)
- Núria Cañete (ORCID: https://orcid.org/0000-0001-9501-7590)
- Christophe Bureau (ORCID: https://orcid.org/0000-0001-8634-9278)
- Luís Téllez (ORCID: https://orcid.org/0000-0002-9254-3891)
- Álvaro Giráldez Gallego (ORCID: https://orcid.org/0000-0001-6849-9272)
- Ares Villagrasa (ORCID: https://orcid.org/0000-0003-0928-0427)
- Helena Masnou Ridaura
- Olivier Deckmyn (ORCID: https://orcid.org/0000-0002-1589-9368)
- Marika Rudler
- S. Mouri (ORCID: https://orcid.org/0000-0001-5623-5122)
- Cándido Villanueva
- Filippo Schepis
- Dhiraj Tripathi
- Edilmar Alvarado Tapias
- Lise Lotte Gluud (ORCID: https://orcid.org/0000-0002-9462-4468)
Institutions
- University of Modena and Reggio Emilia (IT)
- Universitat Autònoma de Barcelona (ES)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- University of Padua (IT)
- Inserm (FR)
- University of Milan (IT)
- Universidad de Alcalá (ES)
- University Hospital Bonn (DE)
- Hospital de Sant Pau (ES)
- Copenhagen University Hospital (DK)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Hospital de São João (PT)
- Sorbonne Université (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Vall d'Hebron Institut de Recerca (ES)
- Biopredic (France) (FR)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- Pitié-Salpêtrière Hospital (FR)
- Hôpital Rangueil (FR)
- Instituto Ramón y Cajal de Investigación Sanitaria (ES)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (ES)
- Instituto de Biomedicina de Sevilla (ES)
- Centre de Recherche Saint-Antoine (FR)
- Fondation pour l’innovation en Cadiométabolisme et Nutrition (FR)
- Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES)
- Hospital Universitario Ramón y Cajal (ES)
- Martin Luther University Halle-Wittenberg (DE)
- Medical University of Vienna (AT)
- KU Leuven (BE)
Publication Details
- Journal
- JHEP Reports
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1016/j.jhepr.2025.101611
- Primary Topic
- Liver Disease and Transplantation
- Type
- article
- Field-Weighted Citation Impact
- 0.00