{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:02:26Z","timestamp":1790787746019,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T00:00:00Z","timestamp":1730764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transjugular intrahepatic portosystemic shunt (TIPSS) is highly effective for treatment of variceal bleeding; however, factors contributing to rebleeding complications remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>In this study, we aim to determine risk factors for recurrent portal hypertensive gastrointestinal bleeding following TIPSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Utilising the Advancing Liver Therapeutic Approaches multicentre database, we retrospectively identified adult patients who underwent TIPSS for secondary prophylaxis of variceal bleeding and had a gastrointestinal rebleeding event within 1\u2009year. We developed multivariable logistic regression models to identify clinical\/procedural characteristics associated with rebleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 476 patients, predominately middle\u2010aged (mean age 57), male (62%) and White (65%), with mean MELD\u2010Na 16. 16% (<jats:italic>n<\/jats:italic>\u2009=\u200977) had a rebleeding event; these patients were more likely to be male (<jats:italic>p<\/jats:italic>\u2009=\u20090.016), with higher serum creatinine (<jats:italic>p<\/jats:italic>\u2009=\u20090.005), MELD\u2010Na (<jats:italic>p<\/jats:italic>\u2009=\u20090.0002), portal hypertensive gastropathy on pre\u2010TIPSS upper endoscopy (<jats:italic>p<\/jats:italic>\u2009=\u20090.000) and with higher incidence of TIPSS revision (<jats:italic>p<\/jats:italic>\u2009=\u20090.000). There were no significant differences in type of TIPSS endoprosthesis, concurrent embolotherapy, and post\u2010TIPSS pressure gradients between those who experienced rebleeding and those who did not. After adjusting for TIPSS revision, multivariable analysis revealed MELD\u2010Na and presence of portal hypertensive gastropathy on pre\u2010TIPSS endoscopy were independently associated with rebleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this retrospective analysis of a multicentre, nationally representative database, we found that apart from TIPSS\u2010related factors, high MELD\u2010Na and portal hypertensive gastropathy on pre\u2010TIPSS endoscopy were independent predictors of rebleeding within 1\u2009year following TIPSS. These variables may be used to identify high\u2010risk patients who may require additional monitoring following TIPSS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18362","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T06:29:17Z","timestamp":1730874557000},"page":"346-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Portal Hypertensive Gastropathy and <scp>MELD<\/scp>\u2010Na Score Predict Recurrent Gastrointestinal Bleeding After <scp>TIPSS<\/scp>: An <scp>ALTA<\/scp> Group Study"],"prefix":"10.1111","volume":"61","author":[{"given":"Kelly","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai","family":"Sedki","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Kwong","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Kesselman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Interventional Radiology Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanti Pallav","family":"Kolli","sequence":"additional","affiliation":[{"name":"Department of Radiology and Biomedical Imaging University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Morelli","sequence":"additional","affiliation":[{"name":"University of Florida Health  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Spengler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine University of Texas Health\u2014San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9944-4071","authenticated-orcid":false,"given":"Adnan","family":"Said","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2092-6380","authenticated-orcid":false,"given":"Jennifer","family":"Lai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of California  San Francisco, San Francisco California 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Gastroenterology and Hepatology, Department of Medicine, Banner University Medical Center University of Arizona College of Medicine \u2013 Phoenix  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"German","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of Wisconsin School of Medicine and Public Health  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Verna","sequence":"additional","affiliation":[{"name":"Department of Medicine Columbia University College of Physicians and Surgeons  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Boike","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois 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