Ascites Results in Significantly Lower Survival After TIPS in Children

Background: Pediatric portal hypertension differs from adult disease. Etiologies differ with extrahepatic portal vein occlusion being the most common etiology followed by biliary atresia. Biliary atresia may result in liver failure early on and require liver transplant. Portal vein occlusion results in variceal bleeding in later childhood. Current management includes medical, endoscopic, surgical, and interventional procedures, all of which can serve as bridges to liver transplant. Surgical shunts may not be possible in cases of portal vein thrombosis extending to the intrahepatic segments, in emergencies, and in cases of cirrhosis or congenital hepatic fibrosis, and long-term patency is limited. Transjugular intrahepatic portosystemic shunt (TIPS) is an alternative to surgical shunt procedures and is less invasive. In adults, TIPS has higher patency rates compared to surgical shunts. Due to the rarity of this disease, although retrospective single-center cohort studies investigating more...