Your new experience awaits. Try the new design now and help us make it even better

SYSTEMATIC REVIEW article

Front. Med.

Sec. Hepatobiliary Diseases

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1625825

Efficacy and safety of transjugular intrahepatic portosystemic shunt in hepatic sinusoidal obstruction syndrome: systematic review and meta-analysis

Provisionally accepted
Xinghe  JiangXinghe Jiang1Xuan  MaXuan Ma1Shuni  TianShuni Tian2Lijun  PengLijun Peng2*
  • 1School of Clinical Medicine, Shandong Second Medical University, Weifang, China
  • 2Linyi City People's Hospital, linyi, China

The final, formatted version of the article will be published soon.

Background: Hepatic sinusoidal obstruction syndrome (HSOS) is a rare but severe liver disorder. The clinical efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) for the management of HSOS remain inadequately established. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of TIPS in the treatment of HSOS. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Cochrane databases for studies investigating TIPS in HSOS patients, published up to November 2024. Data were extracted to assess key outcomes, including the technical success rate, clinical response rate, 3-month and 1-year survival rates, incidence of hepatic encephalopathy (HE), and mean changes in portal vein pressure following TIPS placement. Results: A total of 19 studies were included in the analysis. The pooled technical success rate of TIPS was 100% (95% CI: 99.6-100.0%). The clinical response rate was 94.2% (95% CI: 87.1-99.0%). In HSOS patients undergoing TIPS, the mean reductions in portal pressure gradient (PPG) and portal vein pressure (PVP) were -13.5 mmHg (95% CI: -14.6 to -12.4 mmHg) and -12.3 mmHg (95% CI: -15.1 to -9.5 mmHg), respectively. The pooled 3-month and 1-year survival rates were both 91.6% (95% CI: 82.7-97.9% and 88.1-94.6%, respectively). HE was the most frequently reported complication, with an incidence of 13.2% (95% CI: 7.7-19.6%). Conclusion: TIPS appears to be a effective, and relatively safe therapeutic intervention for HSOS, particularly in cases associated with pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome (PA-HSOS).

Keywords: Hepatic sinusoidal obstruction syndrome, Hepatic Veno-Occlusive Disease, Transjugular intrahepatic portosystemic shunt, portal hypertension, Meta-analysis

Received: 09 May 2025; Accepted: 23 Jul 2025.

Copyright: © 2025 Jiang, Ma, Tian and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Lijun Peng, Linyi City People's Hospital, linyi, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.