A245 A TERTIARY CENTRE REVIEW OF PORTO-SYSTEMIC SHUNTS: AN INCREASINGLY IMPORTANT TOOL IN LIVER DISEASE MANAGEMENT

Abstract Background Portal hypertensive complications arising from chronic liver disease are increasingly prevalent. Radiologically placed porto-systemic shunts used successfully to address such as ascites and recurrent variceal bleeding. Purpose We sought, with approval ethics electronically chart review the UHN experience for TIPSS (transjugular intrahepatic shunt) DIPS (direct porto-caval over time. Method employed a search strategy focused on radiologic databases, identify patients who had received shunt insertion three decades between January 1, 1990, September 14, 2021. A total of 238 that imaged, re-assessed, or inserted were included in this retrospective electronic review. Demographic information was recorded at baseline. Data pertaining clinical outcomes portal hypertension refractory ascites, gastrointestinal bleeding ESLD progression baseline, 1 month, 3 months 6 post-shunt insertion. HVPG pre-shunt Transplant-free survival post-operative also assessed. Patients followed until death transplant. Result(s) Out confirmed, 219 19 The average age time 55.1 ± 8.4 years. 53.7% (n=128) male. Indications portosystemic placement (n=141), (n=73), hydrothorax (n=10), hepatorenal syndrome (n=8), vein thrombosis (n=4). Etiology categorized alcohol-associated (n=107), non-alcohol associated fatty (n=36), viral hepatitis (n=27), autoimmune (n=38) vascular (n=20). Relevant events noted post procedure hepatic encephalopathy (n=34), (n=17), (including stent) (n=17) renal failure 12 2.5% (n=6) died transplant; these 1.7% (n=4) transplanted. HPVG fell consistently post-procedure: 15.6 1.5mmHg 5.9 1.2mmHg post-shunt. There no observable increase MELD-Na score first month Temporal trends showed more aged 50 69, female patients, now receiving than initiation Image Conclusion(s) Portosystemic form is an common effective treatment patents advanced UHN. Disclosure Interest None Declared