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TIPS for Resolving Portal Hypertension in MPN Patients

Am J Hematol; ePub 2017 May 24; Reilly, et al

Transjugular intrahepatic portosystemic shunt (TIPS) can help resolve portal hypertension (pHTN) in patients with myeloproliferative neoplasms (MPNs), according to a retrospective analysis involving 29 individuals. However, TIPS thrombosis occurs frequently.

Participants with MPNs underwent TIPS at 3 academic medical centers between 1997 and 2016. Investigators looked at safety and long-term outcomes. Among the results:

  • Most patients experienced complete clinical resolution of pHTN and its clinical sequelae following TIPS.
  • Overall survival at 1 year was 96%; at 2, 3, and 4 years these rates were 92%, 85%, and 71%, respectively.
  • However, even with therapeutic anticoagulation, in-stent thrombosis occurred in 31% of patients after TIPS.

The authors advised indefinite anticoagulation post-TIPS.

Citation:

Reilly C, Babushok D, Martin K, et al. Multicenter analysis of the use of transjugular intrahepatic portosystemic shunt (TIPS) for management of MPN-associated portal hypertension. [Published online ahead of print May 24, 2017]. Am J Hematol. doi:10.1002/ajh.24798.