Chinese Registry on Transjugular Intrahepatic Portosystemic Shunts (CN‐TIPS): Protocol for a Registry‐Based, Prospective Prognostic Study

ABSTRACT Aims Transjugular intrahepatic portosystemic shunt (TIPS) is an established treatment for complications of portal hypertension in patients with cirrhosis. Despite advances in technique, challenges remain, including variability in procedural workflows, inadequate perioperative management, and limited high‐quality clinical data. This registry is designed to integrate perioperative clinical, imaging, and multi‐omics data to improve risk stratification, guide individualized management, reduce complications, and enhance transplant‐free survival. Methods This multicenter, prospective cohort study will enroll 10,000 adult patients aged 18–75 years with portal hypertension undergoing TIPS at multiple tertiary hospitals in China between 2025 and 2027. Participants will be followed for 2 years after the procedure. The primary outcome will be transplant‐free survival at 2 years. Secondary outcomes include early portosystemic pressure gradient, improvement in portal hypertension‐related complications, the predictive accuracy of computational fluid dynamics simulations, complication rates, and recurrence of portal hypertension‐related complications. Improvement in liver function will also be assessed using serum biomarkers at 3, 6, 12, and 24 months after TIPS. Imaging data will be collected from 3000 patients, with an additional 1000 undergoing multi‐omics analyses. Statistical methods will include Kaplan–Meier survival analysis, Cox proportional hazards regression, and multivariate modeling. Discussion This registry will provide high‐quality, contemporary real‐world evidence to inform standardized TIPS practice and improve prognostic assessment in a large Chinese population. The integrated clinical, hemodynamic, imaging, and multi‐omics framework may enable refined risk stratification and more individualized post‐TIPS management to improve long‐term outcomes. Trial Registration ChiCTR2500105039.