Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation
Abstract Transjugular intrahepatic portosystemic shunt (TIPS) is one of the main treatment options in patients with decompensated liver cirrhosis but is still associated with partly severe complications. For adequate patient selection, prognostic parameters are of crucial importance. The liver maxim...
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doaj-7973f874b0824f02874e33ed5c01fcc62021-07-11T11:26:44ZengNature Publishing GroupScientific Reports2045-23222021-07-0111111010.1038/s41598-021-93392-5Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantationJassin Rashidi-Alavijeh0Alisan Kahraman1Guido Gerken2Jens M. Theysohn3Katharina Willuweit4Dieter P. Hoyer5Christian M. Lange6Matthias Buechter7Department of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenDepartment of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenDepartment of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenDepartment of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-EssenDepartment of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenDepartment of General-, Visceral- and Transplantation Surgery, University Hospital Essen, University of Duisburg-EssenDepartment of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenDepartment of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg-EssenAbstract Transjugular intrahepatic portosystemic shunt (TIPS) is one of the main treatment options in patients with decompensated liver cirrhosis but is still associated with partly severe complications. For adequate patient selection, prognostic parameters are of crucial importance. The liver maximum capacity (LiMAx) breath test measures enzymatic liver function and could potentially represent an efficient prognostic marker. We therefore aimed to assess the role of LiMAx in predicting survival of TIPS patients in a prospective analysis. LiMAx was performed for patients who underwent TIPS implantation between October 2016 and February 2018. Associations with transplant-free survival after 24 weeks were assessed by logistic regression. A total number of 30 patients were included, of whom seven received liver transplantation (N = 2) or died (N = 5) during follow-up. LiMAx values after (P = 0.01, OR = 1.24, 95% CI = 1.04–1.47) and before (P = 0.03, OR 1.21, 95% CI = 1.02–1.43) TIPS implantation and MELD score (P = 0.03, OR = 0.79, 95% CI = 0.63–0.98) were significantly associated with transplant-free survival according to univariate logistic regression. In AUROC analysis, LiMAx at day one after TIPS (sensitivity 85.7%, specificity 78.3%, AUROC 0.85, cut-off ≤ 165 µg/kg/h), LiMAx value at the day before TIPS (sensitivity 100%, specificity 73.9%, AUROC 0.82, cut-off ≤ 205 µg/kg/h) and MELD score (sensitivity 71.4%, specificity 73.9%, AUROC 0.82, cut-off ≥ 15) had the highest prognostic accuracy. LiMAx values prior and after TIPS procedure seem to be good prognostic parameters regarding prediction of transplant-free survival of patients undergoing TIPS implantation.https://doi.org/10.1038/s41598-021-93392-5 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jassin Rashidi-Alavijeh Alisan Kahraman Guido Gerken Jens M. Theysohn Katharina Willuweit Dieter P. Hoyer Christian M. Lange Matthias Buechter |
spellingShingle |
Jassin Rashidi-Alavijeh Alisan Kahraman Guido Gerken Jens M. Theysohn Katharina Willuweit Dieter P. Hoyer Christian M. Lange Matthias Buechter Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation Scientific Reports |
author_facet |
Jassin Rashidi-Alavijeh Alisan Kahraman Guido Gerken Jens M. Theysohn Katharina Willuweit Dieter P. Hoyer Christian M. Lange Matthias Buechter |
author_sort |
Jassin Rashidi-Alavijeh |
title |
Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation |
title_short |
Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation |
title_full |
Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation |
title_fullStr |
Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation |
title_full_unstemmed |
Enzymatic liver function measured by LiMAx is superior to current standard methods in predicting transplant-free survival after TIPS implantation |
title_sort |
enzymatic liver function measured by limax is superior to current standard methods in predicting transplant-free survival after tips implantation |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-07-01 |
description |
Abstract Transjugular intrahepatic portosystemic shunt (TIPS) is one of the main treatment options in patients with decompensated liver cirrhosis but is still associated with partly severe complications. For adequate patient selection, prognostic parameters are of crucial importance. The liver maximum capacity (LiMAx) breath test measures enzymatic liver function and could potentially represent an efficient prognostic marker. We therefore aimed to assess the role of LiMAx in predicting survival of TIPS patients in a prospective analysis. LiMAx was performed for patients who underwent TIPS implantation between October 2016 and February 2018. Associations with transplant-free survival after 24 weeks were assessed by logistic regression. A total number of 30 patients were included, of whom seven received liver transplantation (N = 2) or died (N = 5) during follow-up. LiMAx values after (P = 0.01, OR = 1.24, 95% CI = 1.04–1.47) and before (P = 0.03, OR 1.21, 95% CI = 1.02–1.43) TIPS implantation and MELD score (P = 0.03, OR = 0.79, 95% CI = 0.63–0.98) were significantly associated with transplant-free survival according to univariate logistic regression. In AUROC analysis, LiMAx at day one after TIPS (sensitivity 85.7%, specificity 78.3%, AUROC 0.85, cut-off ≤ 165 µg/kg/h), LiMAx value at the day before TIPS (sensitivity 100%, specificity 73.9%, AUROC 0.82, cut-off ≤ 205 µg/kg/h) and MELD score (sensitivity 71.4%, specificity 73.9%, AUROC 0.82, cut-off ≥ 15) had the highest prognostic accuracy. LiMAx values prior and after TIPS procedure seem to be good prognostic parameters regarding prediction of transplant-free survival of patients undergoing TIPS implantation. |
url |
https://doi.org/10.1038/s41598-021-93392-5 |
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