Table 1.
Demographic and clinical characteristics of all patients by TIPS status.
| No TIPS (n=600) | TIPS (n=40) | P value | |
|---|---|---|---|
|
| |||
| Age at transplant, Median (IQR) | 58.4 (54.0–64.0) | 57.3 (52.7–64.7) | 0.57 |
|
| |||
| Male gender, N (%) | 45 (82.5%) | 33 (82.5%) | 0.99 |
|
| |||
| Etiology, N (%) | |||
| Hepatitis C | 438 (73.0%) | 29 (72.5%) | 0.95 |
| Hepatitis B | 42 (7.0%) | 0 (0.0%) | 0.08 |
| Alcohol | 42 (7.0%) | 4 (10.0%) | 0.48 |
| Autoimmune | 14 (2.3%) | 2 (5.0%) | 0.29 |
| Non-alcoholic steatohepatitis | 14 (2.3%) | 2 (5.0%) | 0.29 |
| Cryptogenic/other | 38 (6.3%) | 3 (7.5%) | 0.78 |
|
| |||
| MELD | |||
| Allocation, Median (IQR) | 25 (22–29) | 24 (21–28) | 0.08 |
| Biochemical, Median (IQR) | 12 (9–18) | 17 (15–22) | <0.001 |
| Exception granted, N (%) | 479 (80.0%) | 24 (60.0%) | 0.003 |
|
| |||
| AFP (ng/mL), Median (IQR) | |||
| At time of listing for transplant | 14 (6–41) | 6 (3–15) | 0.004 |
| Highest prior to-transplant | 18 (7–83) | 10 (5–34) | 0.02 |
| Most recent prior to transplant | 10 (4–28) | 5 (2–17) | 0.02 |
|
| |||
| Days on waitlist, Median (IQR) | 195 (64–397) | 267 (85–990) | 0.09 |
|
| |||
| Pre-transplant treatment*, N (%) | |||
| None | 163 (27.4%) | 28 (70.0%) | <0.001 |
| TACE | 378 (63.1%) | 10 (25.0%) | <0.001 |
| RFA | 76 (12.7%) | 3 (7.5%) | 0.33 |
| Resection | 14 (2.3%) | 0 (0.0%) | 0.33 |
| Radioembolization | 5 (0.8%) | 1 (2.5%) | 0.28 |
| Percutaneous ethanol injection | 3 (0.5%) | 0 (0.0%) | 0.65 |
| Number of treatments | 1 (0–2) | 2 (1–3) | 0.001 |
|
| |||
| Portal venous thrombosis, N (%) | |||
| Incidence | 57 (9.5%) | 6 (15.0%) | 0.26 |
| Site | |||
| Only trunk | 35 (61.4%) | 1 (16.7%) | 0.04 |
| Only branch | 14 (24.6%) | 4 (66.7%) | 0.03 |
| Trunk and branches | 6 (10.5%) | 0 (0.0%) | 0.40 |
| Degree | |||
| Occlusive | 19 (33.3%) | 4 (66.7%) | 0.11 |
| Nonocclusive | 31 (54.4%) | 1 (16.7%) | 0.08 |
| Extent of portal venous system occlusions | |||
| None | 38 (66.7%) | 4 (66.7%) | 1.00 |
| Splenic and/or mesenteric vein | 14 (24.6%) | 1 (16.7%) | 0.85 |
|
| |||
| Most recent pre-transplant imaging, N (%) | |||
| None | 2 (0.3%) | 0 (0.0%) | 0.72 |
| MRI | 478 (79.7%) | 26 (65.0%) | 0.03 |
| CT | 55 (9.2%) | 8 (20.0%) | 0.08 |
| Ultrasound | 12 (2.0%) | 6 (15.0%) | 0.003 |
| Unknown | 53 (8.9%) | 0 (0.0%) | 0.05 |
|
| |||
| Days from imaging to transplant, Median (IQR) | 43 (21–74) | 34 (15–79) | 0.40 |
|
| |||
| Indication for TIPS, N (%) | N/A | N/A | |
| Ascites | 18 (45.0%) | ||
| Variceal bleeding | 10 (25.0%) | ||
| Ascites and bleeding | 3 (7.5%) | ||
| Unknown | 9 (22.5%) | ||
|
| |||
| Pre-TIPS hepatic imaging | N/A | N/A | |
| MRI, N (%) | 8 (20.0%) | ||
| CT, N (%) | 9 (22.5%) | ||
| Ultrasound, N (%) | 3 (7.5%) | ||
| Unknown, N (%) | 20 (50.0%) | ||
| Days between imaging and TIPS placement, Median (IQR) | 54 (10–126) | ||
| Malignancy identified on imaging, N (%) | 1 (2.5%) | ||
|
| |||
| Days between TIPS and transplant, Median (IQR) | N/A | 674 (309–1414) | N/A |
|
| |||
| Pre-transplant imaging | |||
| Number of visualized lesions, N (%) | |||
| 0 | 64 (10.7%) | 19 (47.5%) | <0.001 |
| 1 | 303 (50.5%) | 13 (32.5%) | 0.03 |
| 2 | 152 (25.4%) | 4 (10.0%) | 0.03 |
| 3 or more | 79 (13.2%) | 4 (10.0%) | 0.56 |
| Unknown | 2 (0.3%) | 0 (0.0%) | 0.72 |
| Incidence of indeterminate lesions, N (%) | 190 (31.7%) | 14 (35.0%) | 0.66 |
| Diameter of dominant lesion (mm)**, Median (IQR) | 22 (17–31) | 25 (22–28) | 0.24 |
| Total diameter (mm) of all lesions, Median (IQR)*** | 28 (17–43) | 20 (0.0–40) | 0.009 |
|
| |||
| Explant evaluation | |||
| Number of lesions, Median (IQR) | 2 (1–3) | 2 (1–4) | 0.67 |
| Total diameter (mm) of all lesions, Median (IQR) | 35 (23–56) | 30 (18–53) | 0.18 |
| Occult malignancy, N (%) | 257 (43.1%) | 32 (80.0%) | <0.001 |
| Single occult lesion | 143 (23.9%) | 18 (45.0%) | 0.003 |
| More than one occult lesion | 115 (19.2%) | 14 (35.0%) | 0.02 |
| Outside Milan criteria, N (%) | 166 (28.3%) | 14 (35.0%) | 0.37 |
| Differentiation, N (%) | |||
| Well-differentiated | 102 (17.1%) | 6 (15.0%) | 0.73 |
| Moderately differentiated | 301 (50.3%) | 26 (65.0%) | 0.07 |
| Poorly differentiated | 90 (15.0%) | 6 (15.0%) | 0.99 |
| Invasion, N (%) | |||
| Micro lympho-vascular invasion | 305 (50.9%) | 22 (55.0%) | 0.62 |
| Major vascular invasion | 26 (4.4%) | 3 (7.5%) | 0.79 |
| Hepatocholangiocarcinoma | 20 (3.3%) | 3 (7.5%) | 0.67 |
|
| |||
| Ischemic time, Median (IQR) | |||
| Warm ischemia (minutes) | 54 (48–59) | 55 (50–59) | 0.29 |
| Cold ischemia (hours) | 306 (249–368) | 287 (238–349) | 0.29 |
AFP = alpha-fetoprotein. CT = computerized tomography. IQR = interquartile range. MELD = Model for End-Stage Liver Disease. MRI = magnetic resonance imaging. N= number. RFA = radiofrequency ablation. TACE = trans-arterial chemoembolization.
*
Patients who underwent multiple therapies are repeated in each applicable row.
**
Diameter of dominant lesion on the last pre-transplant image in patients with at least one suspected lesion.
***
Total diameter of all lesions includes patients with no reported malignancy on preoperative imaging.