Clinical outcomes, defined as a 2 point CTP progression, variceal bleeding, ascites, hepatic encephalopathy, or liver-related death, occurred in 54 patients. Results. Patients ranged from DSI 9 (normal) to 40 (severe dysfunction). ROC curves showed that DSI could identify
patients with medium/large varices (c-statistic 0.82), and could predict which patients would have clinical outcomes (c-statistic 0.83), and DSI >25 was the optimum cutoff for both. DSI >25 had a higher balanced accuracy than cirrhosis by biopsy (Ishak F5F6), and the PPV for identifying medium/large varices increased 41% relative to Temozolomide in vitro biopsy and the PPV for predicting outcomes increased 47% (Table 1). Conclusions. A dual cholate liver function test yielding a DSI could outperform histologic fibrosis stage in identifying patients with medium/large varices and in predicting clinical outcomes in chronic HCV patients. Identifying Med/Lg Varices Sens. Spec. PPV NPV Balanced Accuracy Biopsy (Ishak F5-F6) 77% 60% 18% 96% 69% DSI>25 77% 74% 25% 97% 76% Predicting Outcomes Sens. Spec. PPV NPV Balanced Accuracy Biopsy (Ishak F5-F6) 72% 66% 41% 88% 69% DSI>25 74% 84% 60% 91% 79% Disclosures: Steve M. Helmke – Patent Held/Filed: University of Colorado Gregory T. Everson – Advisory
Committees or Review Panels: Roche/Genentech, Merck, HepC Connection, Roche/Genentech, Palbociclib concentration Merck, HepC Connection; Board Membership: HepQuant LLC, PSC Partners, HepQuant LLC, PSC Partners; Consulting: Roche/Genentech, BMS, Gilead, Roche/Genentech, Bristol-Myers Sguibb, Abbott; Grant/Research Support: Roche/Genentech, Pharmassett, Vertex, GSK, Schering-Plough, Bristol-Myers Sguibb, Tibotec, GlobeImmune, Pfizer, Abbott, Conatus, Zymogenetics, PSC Partners, Roche/Genentech, Pharmassett, Vertex, GSK, Phloretin Schering-Plough, Tibotec, Globeimmune, Pfizer, Gilead, Conatus, Zymogenetics, PSC Partners,
Abbott; Management Position: HepQuant LLC, HepQuant LLC; Patent Held/Filed: Univ of Colorado, Univ of Colorado The following people have nothing to disclose: Jennifer DeSanto, Andrea Herman, Asmeen Bhatt, Shannon Lauriski Purpose- This study was undertaken to evaluate short-term survival as well as mid-term outcome after TIPS in patients who successfully underwent the procedure for variceal bleeding. Materials and Methods- Thirty nine consecutive patients with liver cirrhosis who underwent TIPS creation for treatment of vasoactive drug and endoscopy refractory variceal hemorrhage within 24 hours of acute variceal bleed were identified among all patients undergoing TIPS (N=87) over a two year period at our institute. Technical success was defined as successful creation of a shunt between the hepatic vein and an intrahepatic portal venous branch. Hemodynamic success was defined as reduction in the portosystemic pressure gradient to an absolute value less than 12 mm Hg.