{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:32:50Z","timestamp":1762507970546,"version":"3.40.5"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T00:00:00Z","timestamp":1583971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T00:00:00Z","timestamp":1583971200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver Transpl"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Spontaneous portosystemic shunts (SPSSs) have been associated with worse clinical outcomes in the pre\u2013liver transplantation (LT) setting, but little is known about their post\u2010LT impacts. Our aim was to compare LT candidates with and without SPSSs and assess the impact of SPSSs on patient mortality and graft survival in the post\u2010LT setting. Patients 18 years or older with abdominal imaging done prior to LT were included. Exclusion criteria were the presence of pre\u2010LT surgical shunts, LT indications other than cirrhosis, and combined solid organ transplantations. SPSSs were classified as absent, small, or large according to their maximum diameter (8 mm). Multiple variables that could influence the post\u2010LT course were extracted for analysis. Patient and graft survival were estimated using the Kaplan\u2010Meier method and were compared between groups using a log\u2010rank test. The project received institutional review board approval. We extracted data from 326 patients. After comparing patients without SPSS or with small or large SPSSs, no statistical difference was found for overall patient survival: no SPSS (n\u00a0=\u00a08\/63), reference; small SPSS (n\u00a0=\u00a018\/150), hazard ratio (HR), 1.05 (95% confidence interval [CI], 0.45\u20102.46); and large SPSS (n\u00a0=\u00a06\/113), HR, 0.60 (95% CI, 0.20\u20101.78); <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.20. Also, no difference was found for graft survival: no SPSS (n\u00a0=\u00a011\/63), reference; small SPSS (n\u00a0=\u00a021\/150), HR, 0.80 (95% CI, 0.38\u20101.70); large SPSS (n\u00a0=\u00a011\/113), HR, 0.59 (95% CI, 0.25\u20101.40); <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.48. Similarly, no statistical significance was found for these variables when comparing if the graft used was procured from a donation after circulatory death donor versus a donation after brain death donor. In conclusion, the previously described association between SPSSs and worse clinical outcomes in pre\u2010LT patients seems not to persist once patients undergo LT. This study suggests that no steps to correct SPSS intraoperatively are necessary.<\/jats:p>","DOI":"10.1002\/lt.25710","type":"journal-article","created":{"date-parts":[[2019,12,24]],"date-time":"2019-12-24T12:37:28Z","timestamp":1577191048000},"page":"693-701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Outcomes of Portosystemic Shunts on the Outcome of Liver Transplantation"],"prefix":"10.1097","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9684-8273","authenticated-orcid":false,"given":"Eduardo A.","family":"Rodriguez","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic Arizona,Phoenix,AZ"},{"name":"Division of Transplantation Center,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0051-5018","authenticated-orcid":false,"given":"Rachel","family":"Perez","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Health Science Research,Section of Biostatistics,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth S.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Health Science Research,Section of Biostatistics,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Radiology,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7554-975X","authenticated-orcid":false,"given":"Michael A.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidan J.","family":"McGirr","sequence":"additional","affiliation":[{"name":"Department of Radiology,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ananth","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Division of Transplantation Center,Mayo Clinic Arizona,Phoenix,AZ"},{"name":"Division of Transplantation Surgery,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Winston","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Division of Transplantation Center,Mayo Clinic Arizona,Phoenix,AZ"},{"name":"Division of Transplantation Surgery,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvin C.","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Radiology,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7088-9779","authenticated-orcid":false,"given":"Jorge","family":"Rakela","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic Arizona,Phoenix,AZ"},{"name":"Division of Transplantation Center,Mayo Clinic Arizona,Phoenix,AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7802-688X","authenticated-orcid":false,"given":"Hugo E.","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Mayo Clinic Arizona,Phoenix,AZ"},{"name":"Division of Transplantation 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