{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:29:55Z","timestamp":1792189795848,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transjugular intrahepatic portosystemic shunt (TIPS) placement leads to a reduction in portal pressure and an improvement in survival in patients with recurrent and refractory ascites and variceal haemorrhage. Prediction of post\u2010TIPS survival is primarily determined by factors identified before the TIPS procedure, as data collected during or after TIPS implantation are limited. The aim of the study was to evaluate the influence of early hemodynamic changes after TIPS placement on survival, in order to refine post TIPS management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective bicentric study, consecutive patients (<jats:italic>n<\/jats:italic>\u2009=\u2009105) undergoing TIPS placement for ascites or variceal haemorrhage underwent measurement of portal pressure gradient (PPG) immediately at TIPS insertion (PPG0) and 24\u2009h later (PPG24h) and the \u0394PPG was calculated from PPG24h and PPG0 (\u0394PPG\u2009=\u2009PPG24h\u2010PPG0). Kaplan\u2013Meier survival analysis and uni\u2010 and multivariable regression analyses were conducted to identify survival predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with lack of increased \u0394PPG exhibited poorer 90\u2010day and 1\u2010year survival compared to patients with increased \u0394PPG. This worse survival was independent of The Model for End\u2010Stage Liver Disease (MELD) score, Child\u2010Pugh score, bilirubin levels, creatinine and the Freiburg index of post\u2010TIPS survival (FIPS)\u2009&gt;\u20090.92. Among these patients with poorer outcome, elevated bilirubin (&gt;\u200925\u2009\u03bcmol\/L) further distinguished survivors from non\u2010survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Lack of increased \u0394PPG post\u2010TIPS insertion identifies a high\u2010risk patient group with worse survival. We propose incorporating this second PPG measurement and determining \u0394PPG into clinical practice to identify these patients early and tailor post\u2010TIPS patient care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.18503","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T05:30:36Z","timestamp":1737005436000},"page":"1175-1182","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Early Dynamics of Portal Pressure Gradient After <scp>TIPS<\/scp> Insertion Predict Mortality"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-475X","authenticated-orcid":false,"given":"P. A.","family":"Reuken","sequence":"first","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2778-2447","authenticated-orcid":false,"given":"T. H.","family":"Wirtz","sequence":"additional","affiliation":[{"name":"Medical Department III University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9704-4741","authenticated-orcid":false,"given":"C.","family":"Ripoll","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Aschenbach","sequence":"additional","affiliation":[{"name":"Department of Radiology Jena University Hospital, Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Teichgr\u00e4ber","sequence":"additional","affiliation":[{"name":"Department of Radiology Jena University Hospital, Friedrich\u2010Schiller\u2010University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. R.","family":"Pollmanns","sequence":"additional","affiliation":[{"name":"Medical Department III University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kiehntopf","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Diagnostics Jena University Hospital, Friedrich\u2010Schiller University  Jena Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Keil","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kuhl","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology University Hospital RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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