The Impact of Transjugular Intrahepatic Portosystemic Shunt on Nutrition in Liver Cirrhosis Patients: A Systematic Review

• Published in: Nutrients Vol. 15; no. 7; p. 1617
• Main Authors: Gazda, Jakub, Di Cola, Simone, Lapenna, Lucia, Khan, Saniya, Merli, Manuela
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.03.2023; MDPI
• Subjects: Adipose tissue; Ascites; Bias; Body composition; Body fat; Body mass; Body mass index; Body size; Care and treatment; Cirrhosis; Citation analysis; Complications; Complications and side effects; Evaluation; fat tissue; Hepatic encephalopathy; Hepatic Encephalopathy - etiology; Humans; Hypertension; Hypertension, Portal - complications; Hypertension, Portal - surgery; Literature reviews; Liver; Liver cirrhosis; Liver Cirrhosis - complications; Liver Cirrhosis - surgery; Liver diseases; Malnutrition; Mortality; Muscle function; Muscles; Musculoskeletal system; Nutrition; Nutrition assessment; Nutritional Status; Portacaval anastomosis; Portasystemic Shunt, Transjugular Intrahepatic - adverse effects; Portasystemic Shunt, Transjugular Intrahepatic - methods; Review; Risk factors; Sarcopenia; Systematic review; transjugular intrahepatic portosystemic shunt; Slovakia; nutritional status; fat tissue; transjugular intrahepatic portosystemic shunt; liver cirrhosis; sarcopenia
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15071617

Liver cirrhosis leads to clinically significant portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) has been shown to effectively reduce the degree of portal hypertension and treat its complications. However, poor nutritional status has been shown to be associated with hepatic encephalopathy, acute on chronic liver failure, and mortality following TIPS placement. The purpose of this systematic review is to create another perspective and evaluate the effect of TIPS placement on the nutritional status of patients with liver cirrhosis. A comprehensive search of four major electronic databases was conducted to identify studies that assessed the nutritional status of cirrhotic patients before and after TIPS placement. The risk of bias was evaluated using ROBINS-I guidelines. Fifteen studies were analyzed in this review. The results indicate that among the 11 studies that evaluated changes in ascites-free weight and body mass index or body cell mass, 10 reported an improvement in one or more measures. Furthermore, all seven studies that evaluated changes in muscle mass demonstrated an increase in muscle mass. Among the four studies that evaluated subcutaneous fat tissue, three showed a significant expansion, while two out of three studies evaluating visceral fat tissue reported a significant reduction. The results of this systematic review suggest that TIPS placement is associated with improvement in the nutritional status of cirrhotic patients, indicated by an increase in ascites-free weight, body mass index, and muscle mass. Additionally, TIPS placement leads to a shift in the distribution of fat mass, with a preference for subcutaneous over visceral adipose tissue. Notably, sarcopenic patients seem to benefit the most from TIPS placement in terms of nutritional status.