Table 3. Summary of the included publications describing patients with hepatosplenic schistosomiasis treated with TIPS.
| First author | Year | Country | N Sch patients | Previous variceal bleeding | Previous treatments | Length of follow-up | Principal findings |
|---|---|---|---|---|---|---|---|
| Richter [75] | 2015 | Germany (patient from Guinea) |
1 | Yes | Variceal band ligation | 3 years | • Pre-TIPS, the patient had splenomegaly, thrombocytopenia, leukopenia, anaemia, increased INR and PTT, and large varices. • Post-TIPS, there was regression of grade 1 varices; no information on spleen size and hematological parameters are provided. • One episode of hepatic encephalopathy occurred, concomitant to acute viral gastroenteritis. • TIPS needed revision due to displacement after 10 months. |
| Grieco [102] | 2016 | Italy (patient from Ethiopia) |
1 | Yes | Variceal band ligation | Not reported | • Pre-TIPS, the patient has splenomegaly, thrombocytopenia, leukopenia, anaemia, slightly increased INR, and moderate ascites. • Post-TIPS, there was no immediate episode of hepatic encephalopathy. • No follow-up outcome data are reported. |
| Kraef [100] | 2019 | Germany (patient from Philippines, Sierra Leone, and Eritrea) |
3 | Patient 1 –Yes (unclear HBV coinfection) |
Variceal band ligation + carvedilol | 9 months | • Pre-TIPS, the patients had grade II/III varices. • Post-TIPS, no further bleeding and occurrence of 2 episodes of mild hepatic encephalopathy. • No information on spleen size and haematochemical parameters. |
| Patient 2 –Yes | Variceal band ligation | 24 months | • Pre-TIPS, the patient had splenomegaly and pancytopenia and grade III varices. • Post-TIPS, regression of varices, no episodes of rebleeding and no episodes of hepatic encephalopathy were observed; no changes of the spleen size or hematological parameters |
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| Patient 3 –No | Variceal band ligation | 48 months | • Pre-TIPS, there was massive splenomegaly, pancytopenia, grade II varices • Post-TIPS, there was no episode of rebleeding and no episode of hepatic encephalopathy; no information on varices or spleen size, or hematological parameters |
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| Liu J [99] | 2019 | China | 20 | Yes (n = 16); No but refractory ascites (n = 4) |
Variceal band ligation (n = 9); EGDS (n = 12) | Mean 15 months (2–30) | • Pre-TIPS, in those with UGB, in 7 bleeding was from esophageal and in 9 from gastric varices; these were embolized during TIPS procedure; mean spleen size increased; mean prothrombin time moderately increased, mean platelet count normal • Post-TIPS, hepatic encephalopathy occurred in 25% (5/20) of patients, UGB in 15% (3/20; not specified if from esophageal or gastric varices); mortality was 15% (3/20; n = 1 from renal failure; n = 2 from UGB) |
EGDS, esophagogastric devascularization procedure with splenectomy; INR, intentional normalized ratio; PTT, partial thromboplastin time; Sch, schistosomiasis; TIPS, transjugular intrahepatic portosystemic shunt; UGB, upper gastrointestinal bleeding.