Author/Authors :
Li, Hong-bin Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Yue, Zhen-dong Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Zhao, Hong-wei Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Wang, Lei Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Fan, Zhen-hua Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , He, Fu-liang Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Dong, Xiao-qun Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China , Liu, Fu-quan Department of Interventional Terapy - Beijing Shijitan Hospital - Capital Medical University, China
Abstract :
Background
Post-TIPS hepatic encephalopathy (PSE) is a complex process involving numerous risk factors; the root cause is unclear, but an elevation of blood ammonia due to portosystemic shunt and metabolic disorders in hepatocytes has been proposed as an important risk factor.
Aims
The aim of this study was to investigate the impact of pathological features of mitochondrial ultrastructure on PSE via transjugular liver biopsy at TIPS implantation.
Methods
We evaluated the pathological damage of mitochondrial ultrastructure on recruited patients by the Flameng classification system. A score ≤2 (no or low damage) was defined as group A, and a score >2 (high damage level) was defined as group B; routine follow-up was required at 1 and 2 years; the incidence of PSE and multiple clinical data were recorded.
Results
A total of 78 cases in group A and 42 in group B completed the study. The incidence of PSE after 1 and 2 years in group B (35.7% and 45.2%, respectively) was significantly higher than that in group A (16.7% and 24.4%, respectively); the 1- and 2-year or (95% CI) were 2.778 (1.166-6.615) and 2.565 (1.155-5.696), respectively, for groups A and B. Importantly, group B had worse incidence of PSE than group A [P=0.014, hazard ratio (95%CI): 2.172 (1.190-4.678)].
Conclusion
Aggressive damage to mitochondrial ultrastructure in liver shunt predicts susceptibility to PSE. The registration number is NCT02540382.
Keywords :
Pathological Features , Mitochondrial Ultrastructure , Predict Susceptibility , Post-TIPS Hepatic Encephalopathy
