Decreasing interleukin-6 levels after TIPS predict outcomes in decompensated cirrhosis

作者：Andrea Kornfehl, Anja Tiede, Paul Hemetsberger, Julia Kappel, Theresa Bucsics, Lena Stockhoff, Hannah Rieland, Lukas Reider, Nina Dominik, Georg Kramer, Michael Trauner, Mattias Mandorfer, Christine S. Falk, Benjamin Maasoumy, Thomas Reiberger, Lukas Hartl · 发表于：JHEP Reports · 年份：2024 · DOI：10.1016/j.jhepr.2024.101308 · 被引用次数：17 · 研究领域：Liver Disease and Transplantation、Immune Response and Inflammation、Nutrition and Health in Aging

Background & Aims Transjugular intrahepatic portosystemic shunt (TIPS) effectively treats complications of cirrhosis. Systemic inflammation (SI) is linked to acute-on-chronic liver failure (ACLF) and liver-related death. We aimed to assess the trajectory and clinical impact of SI parameters after TIPS implantation. Methods Consecutive patients undergoing elective implantation of covered TIPS for recurrent/refractory ascites or portal-hypertensive bleeding at the Medical University Vienna (NCT03409263; n = 58) and at the Hannover Medical School (NCT04801290, n = 51) were included. IL-6 was assessed at baseline (BL), 3 months (M3) and up to 6 (M6; Hannover cohort) or 9 months (M9; Vienna cohort) of follow-up; C-reactive protein (CRP) and lipopolysaccharide-binding protein (LBP) were assessed in the Vienna cohort only. Results In 109 patients (66.1% male, median age 57 years) receiving TIPS mainly (72.4%) by indication ascites the median BL IL-6 levels were 10.5 pg/ml; and 41.3% (n = 45/109) patients exhibiting IL-6 ≥14 pg/ml. From BL to M3, IL-6 decreased in 63.8% (n = 37/58; Vienna cohort) and in 68.6% (n = 35/51; Hannover cohort) of patients, respectively. Similar rates of decreases were observed also for CRP (in 62.1%) and for LBP (in 77.4%). A considerable IL-6 reduction (≥50% of baseline) was noted in 41 (37.6%) patients during follow-up. Competing risk regression in the combined cohort adjusted for age, albumin, and model for end-stage liver disease revealed that IL-6 dec...