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Background and Aim: An increasing number of patients with autoimmune hepatitis (AIH)-induced cirrhosis and variceal bleeding are currently referred for transjugular intrahepatic portosystemic shunt (TIPS). The aim of this study was to evaluate the safety and efficacy of TIPS in such patients, and to compare these results with data from patients with hepatitis B virus (HBV)-induced cirrhosis. Materials and Methods: This retrospective study consisted of 211 patients between August 2016 and May 2021, and patients were allocated to AIH (n = 35) and HBV (n = 176) groups according to the etiology of the cirrhosis. The primary endpoint was mortality after TIPS use; the secondary endpoints were recurrent bleeding, overt hepatic encephalopathy (OHE), shunt dysfunction, and dynamic changes in liver function over time. Results: During a median follow-up period of 27 months, 23 (10.9%) patients died, 22 (10.4%) experienced recurrent bleeding, 50 (23.7%) experienced OHE, and 25 (11.8%) developed shunt dysfunction. Compared with the HBV group, the AIH group exhibited a similar mortality risk (adjusted hazard ratio, HR 1.199; 95% confidence interval, CI 0.367–3.917; p = 0.764), OHE (adjusted HR 1.023, 95% CI 0.483–2.167, p = 0.954), and shunt dysfunction (adjusted HR 0.862, 95% CI 0.285–2.610, p = 0.792); but a higher risk of recurrent bleeding (adjusted HR 2.731, 95% CI 1.112–6.708, p = 0.028). The dynamic changes in liver function manifested an initial trend toward deterioration, and then subsequent recovery in both the AIH and HBV groups. Conclusions: TIPS is a safe and effective treatment, and should be considered for those patients with AIH-induced cirrhosis and variceal bleeding. [ABSTRACT FROM AUTHOR]

Aims: To investigate the impact of endovascular (EV) treatment on liver cirrhosis in Chinese patients with Budd–Chiari syndrome (BCS). Methods: From September 2011 to March 2022, 97 patients from four hospitals in China who were diagnosed with primary BCS complicated with liver cirrhosis and received EV treatment were retrospectively enrolled in this study for clinical analysis. In addition, liver tissues for basic research were acquired from 25 patients between June 2022 and March 2023, including six with benign liver tumors, 11 with BCS before EV treatment, and eight with EV‐treated BCS. Liver cirrhosis was assessed by clinical outcomes, histological studies, and the expression of related genes at the mRNA and protein levels. Results: The patients with BCS had better liver function after EV treatment, evidenced by an increased albumin level and reduced total bilirubin, ALT, and AST. The imaging findings suggested an amelioration of liver cirrhosis and portal hypertension, including increased portal vein velocity (13.52 ± 8.89 cm/s vs. 17.51 ± 6.67 cm/s, p < 0.001) and decreased liver stiffness (30.37 ± 6.39 kPa vs. 23.70 ± 7.99 kPa, p < 0.001), portal vein diameter (14.97 ± 3.42 mm vs. 13.36 ± 2.89 mm, p < 0.001), and spleen volume (870.00 ± 355.61 cm3 vs. 771.36 ± 277.45 cm3, p < 0.001). Furthermore, histological studies revealed that EV treatment resulted in a restoration of liver architecture with reduced extracellular matrix deposition. Meanwhile, hepatic angiogenesis and inflammation, which have a close relationship with cirrhosis, were also inhibited. In addition, the state of hepatocytes switches from apoptosis to proliferation after EV treatment. Conclusions: BCS‐induced liver cirrhosis could be reversed by EV treatment from macroscopic to microscopic dimensions. Our study may provide further insights into understanding BCS and treating cirrhosis. [ABSTRACT FROM AUTHOR]