Volume 154, Issue 6, Pages e4 (May 2018)

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Volume 154, Issue 6, Pages 1694-1705.e4 (May 2018) Association Between Portosystemic Shunts and Increased Complications and Mortality in Patients With Cirrhosis Macarena Simón-Talero, Davide Roccarina, Javier Martínez, Katharina Lampichler, Anna Baiges, Gavin Low, Elba Llop, Michael Praktiknjo, Martin H. Maurer, Alexander Zipprich, Michela Triolo, Guillaume Vangrinsven, Rita Garcia-Martinez, Annette Dam, Avik Majumdar, Carmen Picón, Daniel Toth, Anna Darnell, Juan G. Abraldes, Marta Lopez, Guido Kukuk, Aleksander Krag, Rafael Bañares, Wim Laleman, Vincenzo La Mura, Cristina Ripoll, Annalisa Berzigotti, Jonel Trebicka, Jose Luis Calleja, Puneeta Tandon, Virginia Hernandez-Gea, Thomas Reiberger, Agustín Albillos, Emmanuel A. Tsochatzis, Salvador Augustin, Joan Genescà Sergi Quiroga, Dominic Yu, Luis Téllez, Mattias Mandorfer, Juan Carlos Garcia-Pagan, Claudia Berbel, Jose Ferrusquia, Michel Ble, Mari Angeles Garcia-Criado, Ernest Belmonte, Michael Ney, Cristina Margini, Stefania Casu, Giuseppe Murgia, Christiane Ludwig, Martin Rönsch, Dietrich Stoevesandt, Laura Carrion, Enrique Ramón Botella Macarena Simón-Talero, Davide Roccarina, Javier Martínez, Katharina Lampichler, Anna Baiges, Gavin Low, Elba Llop, Michael Praktiknjo, Martin H. Maurer, Alexander Zipprich, Michela Triolo, Guillaume Vangrinsven, Rita Garcia-Martinez, Annette Dam, Avik Majumdar, Carmen Picón, Daniel Toth, Anna Darnell, Juan G. Abraldes, Marta Lopez, Guido Kukuk, Aleksander Krag, Rafael Bañares, Wim Laleman, Vincenzo La Mura, Cristina Ripoll, Annalisa Berzigotti, Jonel Trebicka, Jose Luis Calleja, Puneeta Tandon, Virginia Hernandez-Gea, Thomas Reiberger, Agustín Albillos, Emmanuel A. Tsochatzis, Salvador Augustin, Joan Genescà Sergi Quiroga, Dominic Yu, Luis Téllez, Mattias Mandorfer, Juan Carlos Garcia-Pagan, Claudia Berbel, Jose Ferrusquia, Michel Ble, Mari Angeles Garcia-Criado, Ernest Belmonte, Michael Ney, Cristina Margini, Stefania Casu, Giuseppe Murgia, Christiane Ludwig, Martin Rönsch, Dietrich Stoevesandt, Laura Carrion, Enrique Ramón Botella Gastroenterology Volume 154, Issue 6, Pages 1694-1705.e4 (May 2018) DOI: 10.1053/j.gastro.2018.01.028 Copyright © 2018 AGA Institute Terms and Conditions

Gastroenterology 2018 154, 1694-1705. e4DOI: (10. 1053/j. gastro. 2018 Copyright © 2018 AGA Institute Terms and Conditions

Figure 1 Flow diagram of participants in the study. HCC: Hepatocellular carcinoma; TIPS: Transjugular intrahepatic portosystemic shunt; L-SPSS: Large spontaneous portosystemic shunt; S-SPSS: Small SPSS; W-SPSS: Without SPSS. Gastroenterology 2018 154, 1694-1705.e4DOI: (10.1053/j.gastro.2018.01.028) Copyright © 2018 AGA Institute Terms and Conditions

Figure 2 Probability of transplant-free survival in all patients included in the study categorized according to the presence of spontaneous portosystemic shunts (SPSS) using Kaplan-Meier curves. Log-rank test: P < .001. L-SPSS: Large SPSS; S-SPSS: Small SPSS; W-SPSS: Without SPSS. Gastroenterology 2018 154, 1694-1705.e4DOI: (10.1053/j.gastro.2018.01.028) Copyright © 2018 AGA Institute Terms and Conditions

Figure 3 Probability of survival in patients with SPSS compared to patients without SPSS categorized according to MELD score subgroups (tertiles). SPSS: Spontaneous portosystemic shunts. W-SPSS: Without-SPSS. Gastroenterology 2018 154, 1694-1705.e4DOI: (10.1053/j.gastro.2018.01.028) Copyright © 2018 AGA Institute Terms and Conditions

Supplementary Figure 1 Presence and size of SPSS according to MELD score subgroups (A) and Child-Pugh classes (B). Data are shown as percentages. L-SPSS: Large-Spontaneous portosystemic shunt; S-SPSS: Small-SPSS; W-SPSS: Without-SPSS. Gastroenterology 2018 154, 1694-1705.e4DOI: (10.1053/j.gastro.2018.01.028) Copyright © 2018 AGA Institute Terms and Conditions

Supplementary Figure 2 Probability of transplant-free survival for W-SPSS and SPSS (L-SPSS and S-SPSS) in Child-Pugh A patients. SPSS: Spontaneous portosystemic shunt; W-SPSS: Without-SPSS. Gastroenterology 2018 154, 1694-1705.e4DOI: (10.1053/j.gastro.2018.01.028) Copyright © 2018 AGA Institute Terms and Conditions