{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T09:18:02Z","timestamp":1776503882601,"version":"3.51.2"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment of refractory ascites in liver cirrhosis is challenging. Transjugular intrahepatic portosystemic shunt and alfapump\u00ae have been proposed for the management, but few data comparing both exist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to evaluate the characteristics and outcomes of patients treated with transjugular intrahepatic portosystemic shunt and alfapump\u00ae for refractory ascites at our centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All consecutive patients were retrospectively reviewed for baseline characteristics, efficacy of treatment, complications and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 19 patients with transjugular intrahepatic portosystemic shunt and 40 patients with alfapump\u00ae were included. Patients with transjugular intrahepatic portosystemic shunt had better liver function and less hepatic encephalopathy at baseline. Fifty\u2010eight per cent of patients developed hepatic encephalopathy in the first six months after transjugular intrahepatic portosystemic shunt. In patients with alfapump\u00ae, renal function decreased and 58% developed prerenal impairment and 43% hepatorenal syndrome in the first six months. Alfapump\u00ae patients with new catheters required less reinterventions (26% versus 57% with old catheters, <jats:italic>p<\/jats:italic> \u2009=\u20090.049). Transplant\u2010free survival at 1 year was 25% in alfapump\u00ae and 65% in transjugular intrahepatic portosystemic shunt. Hepatic encephalopathy predicted transplant\u2010free survival in patients with alfapump\u00ae (hazard ratio 2.00, 95% confidence interval 0.99\u20134.02, <jats:italic>p<\/jats:italic> \u2009=\u20090.05). In a sensitivity analysis comparing patients with similar liver function, the rate of hepatorenal syndrome and prerenal impairment was higher in patients with alfapump\u00ae and these patients were hospitalised more frequently, whereas the rate of hepatic encephalopathy was similar in both treatment groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both transjugular intrahepatic portosystemic shunt and alfapump\u00ae were effective treatments for refractory ascites in cirrhosis. Patients treated with transjugular intrahepatic portosystemic shunt had a better one\u2010year transplant\u2010free survival but had less negative prognostic factors at baseline. Selecting patients without hepatic encephalopathy prior to implantation of an alfapump\u00ae might improve transplant\u2010free survival.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640620938525","type":"journal-article","created":{"date-parts":[[2020,6,26]],"date-time":"2020-06-26T18:39:44Z","timestamp":1593196784000},"page":"961-969","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Transjugular intrahepatic portosystemic shunt and alfapump\u00ae system for refractory ascites in liver cirrhosis: Outcomes and complications"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4623-9554","authenticated-orcid":false,"given":"Valerie","family":"Will","sequence":"first","affiliation":[{"name":"Hepatology University Clinic for Visceral Surgery and Medicine Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana 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