Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality

Christian Jansen, Philipp Möller, Carsten Meyer, Carl Christian Kolbe, Christopher Bogs, Alessandra Pohlmann, Robert Schierwagen, Michael Praktiknjo, Zeinab Abdullah, Jennifer Lehmann, Daniel Thomas, Christian P Strassburg, Eicke Latz, Sebastian Mueller, Martin Rössle, Jonel Trebicka

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Resumé

Transjugular intrahepatic portosystemic shunt (TIPS) efficiently treats complications of portal hypertension. Liver and spleen stiffness might predict clinically significant portal hypertension. This prospective study investigated liver stiffness in patients receiving TIPS regardless of indication. Of 83 included patients, 16 underwent transient elastography immediately before and 30 minutes after TIPS (acute group), while 67 received shear wave elastography of liver and spleen 1 day before and 7 days after TIPS (chronic group) and were followed further. In blood samples obtained before TIPS from cubital, portal, and hepatic veins, levels of several interleukins (IL1b, IL6, IL8, IL10, IL18) and interferon-gamma were analyzed. In 27 patients (5 acute, 22 chronic), it resulted in an increase in liver stiffness of >10%. In 56 patients, liver stiffness decreased or remained unchanged (<10%). Importantly, spleen stiffness measured by shear wave elastography decreased in all patients (chronic group). None of the clinical or laboratory parameters differed between patients with increase in liver stiffness and those without. Of note, patients with increased liver stiffness showed higher overall and/or hepatic venous levels of proinflammatory cytokines at TIPS and higher incidence of organ failure and worse survival after TIPS. C-reactive protein values and increase of >10% in liver stiffness after TIPS were the only independent predictors of mortality in these patients.

CONCLUSION: This study demonstrates that the presence of systemic inflammation predisposes patients to develop increased liver stiffness after TIPS, a predictor of organ failure and death. (NCT03072615) (Hepatology 2018;67:1472-1484).

OriginalsprogEngelsk
TidsskriftHepatology (Baltimore, Md.)
Vol/bind67
Udgave nummer4
Sider (fra-til)1472-1484
ISSN0270-9139
DOI
StatusUdgivet - 1. apr. 2018

Fingeraftryk

Transjugular Intrahepatic Portasystemic Shunt
Liver
Portal Hypertension
Interleukin-18
Hepatic Veins
Gastroenterology
Portal Vein
Interleukin-8
Interleukin-10
Interferon-gamma
Interleukin-6
Prospective Studies

Citer dette

Jansen, Christian ; Möller, Philipp ; Meyer, Carsten ; Kolbe, Carl Christian ; Bogs, Christopher ; Pohlmann, Alessandra ; Schierwagen, Robert ; Praktiknjo, Michael ; Abdullah, Zeinab ; Lehmann, Jennifer ; Thomas, Daniel ; Strassburg, Christian P ; Latz, Eicke ; Mueller, Sebastian ; Rössle, Martin ; Trebicka, Jonel. / Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality. I: Hepatology (Baltimore, Md.). 2018 ; Bind 67, Nr. 4. s. 1472-1484.
@article{cf0e8277a8f54e2fa41877382f33c96a,
title = "Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality",
abstract = "Transjugular intrahepatic portosystemic shunt (TIPS) efficiently treats complications of portal hypertension. Liver and spleen stiffness might predict clinically significant portal hypertension. This prospective study investigated liver stiffness in patients receiving TIPS regardless of indication. Of 83 included patients, 16 underwent transient elastography immediately before and 30 minutes after TIPS (acute group), while 67 received shear wave elastography of liver and spleen 1 day before and 7 days after TIPS (chronic group) and were followed further. In blood samples obtained before TIPS from cubital, portal, and hepatic veins, levels of several interleukins (IL1b, IL6, IL8, IL10, IL18) and interferon-gamma were analyzed. In 27 patients (5 acute, 22 chronic), it resulted in an increase in liver stiffness of >10{\%}. In 56 patients, liver stiffness decreased or remained unchanged (<10{\%}). Importantly, spleen stiffness measured by shear wave elastography decreased in all patients (chronic group). None of the clinical or laboratory parameters differed between patients with increase in liver stiffness and those without. Of note, patients with increased liver stiffness showed higher overall and/or hepatic venous levels of proinflammatory cytokines at TIPS and higher incidence of organ failure and worse survival after TIPS. C-reactive protein values and increase of >10{\%} in liver stiffness after TIPS were the only independent predictors of mortality in these patients.CONCLUSION: This study demonstrates that the presence of systemic inflammation predisposes patients to develop increased liver stiffness after TIPS, a predictor of organ failure and death. (NCT03072615) (Hepatology 2018;67:1472-1484).",
author = "Christian Jansen and Philipp M{\"o}ller and Carsten Meyer and Kolbe, {Carl Christian} and Christopher Bogs and Alessandra Pohlmann and Robert Schierwagen and Michael Praktiknjo and Zeinab Abdullah and Jennifer Lehmann and Daniel Thomas and Strassburg, {Christian P} and Eicke Latz and Sebastian Mueller and Martin R{\"o}ssle and Jonel Trebicka",
note = "{\circledC} 2017 by the American Association for the Study of Liver Diseases.",
year = "2018",
month = "4",
day = "1",
doi = "10.1002/hep.29612",
language = "English",
volume = "67",
pages = "1472--1484",
journal = "Hepatology",
issn = "0270-9139",
publisher = "JohnWiley & Sons, Inc.",
number = "4",

}

Jansen, C, Möller, P, Meyer, C, Kolbe, CC, Bogs, C, Pohlmann, A, Schierwagen, R, Praktiknjo, M, Abdullah, Z, Lehmann, J, Thomas, D, Strassburg, CP, Latz, E, Mueller, S, Rössle, M & Trebicka, J 2018, 'Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality', Hepatology (Baltimore, Md.), bind 67, nr. 4, s. 1472-1484. https://doi.org/10.1002/hep.29612

Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality. / Jansen, Christian; Möller, Philipp; Meyer, Carsten; Kolbe, Carl Christian; Bogs, Christopher; Pohlmann, Alessandra; Schierwagen, Robert; Praktiknjo, Michael; Abdullah, Zeinab; Lehmann, Jennifer; Thomas, Daniel; Strassburg, Christian P; Latz, Eicke; Mueller, Sebastian; Rössle, Martin; Trebicka, Jonel.

I: Hepatology (Baltimore, Md.), Bind 67, Nr. 4, 01.04.2018, s. 1472-1484.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality

AU - Jansen, Christian

AU - Möller, Philipp

AU - Meyer, Carsten

AU - Kolbe, Carl Christian

AU - Bogs, Christopher

AU - Pohlmann, Alessandra

AU - Schierwagen, Robert

AU - Praktiknjo, Michael

AU - Abdullah, Zeinab

AU - Lehmann, Jennifer

AU - Thomas, Daniel

AU - Strassburg, Christian P

AU - Latz, Eicke

AU - Mueller, Sebastian

AU - Rössle, Martin

AU - Trebicka, Jonel

N1 - © 2017 by the American Association for the Study of Liver Diseases.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Transjugular intrahepatic portosystemic shunt (TIPS) efficiently treats complications of portal hypertension. Liver and spleen stiffness might predict clinically significant portal hypertension. This prospective study investigated liver stiffness in patients receiving TIPS regardless of indication. Of 83 included patients, 16 underwent transient elastography immediately before and 30 minutes after TIPS (acute group), while 67 received shear wave elastography of liver and spleen 1 day before and 7 days after TIPS (chronic group) and were followed further. In blood samples obtained before TIPS from cubital, portal, and hepatic veins, levels of several interleukins (IL1b, IL6, IL8, IL10, IL18) and interferon-gamma were analyzed. In 27 patients (5 acute, 22 chronic), it resulted in an increase in liver stiffness of >10%. In 56 patients, liver stiffness decreased or remained unchanged (<10%). Importantly, spleen stiffness measured by shear wave elastography decreased in all patients (chronic group). None of the clinical or laboratory parameters differed between patients with increase in liver stiffness and those without. Of note, patients with increased liver stiffness showed higher overall and/or hepatic venous levels of proinflammatory cytokines at TIPS and higher incidence of organ failure and worse survival after TIPS. C-reactive protein values and increase of >10% in liver stiffness after TIPS were the only independent predictors of mortality in these patients.CONCLUSION: This study demonstrates that the presence of systemic inflammation predisposes patients to develop increased liver stiffness after TIPS, a predictor of organ failure and death. (NCT03072615) (Hepatology 2018;67:1472-1484).

AB - Transjugular intrahepatic portosystemic shunt (TIPS) efficiently treats complications of portal hypertension. Liver and spleen stiffness might predict clinically significant portal hypertension. This prospective study investigated liver stiffness in patients receiving TIPS regardless of indication. Of 83 included patients, 16 underwent transient elastography immediately before and 30 minutes after TIPS (acute group), while 67 received shear wave elastography of liver and spleen 1 day before and 7 days after TIPS (chronic group) and were followed further. In blood samples obtained before TIPS from cubital, portal, and hepatic veins, levels of several interleukins (IL1b, IL6, IL8, IL10, IL18) and interferon-gamma were analyzed. In 27 patients (5 acute, 22 chronic), it resulted in an increase in liver stiffness of >10%. In 56 patients, liver stiffness decreased or remained unchanged (<10%). Importantly, spleen stiffness measured by shear wave elastography decreased in all patients (chronic group). None of the clinical or laboratory parameters differed between patients with increase in liver stiffness and those without. Of note, patients with increased liver stiffness showed higher overall and/or hepatic venous levels of proinflammatory cytokines at TIPS and higher incidence of organ failure and worse survival after TIPS. C-reactive protein values and increase of >10% in liver stiffness after TIPS were the only independent predictors of mortality in these patients.CONCLUSION: This study demonstrates that the presence of systemic inflammation predisposes patients to develop increased liver stiffness after TIPS, a predictor of organ failure and death. (NCT03072615) (Hepatology 2018;67:1472-1484).

U2 - 10.1002/hep.29612

DO - 10.1002/hep.29612

M3 - Journal article

C2 - 29059466

VL - 67

SP - 1472

EP - 1484

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 4

ER -