Liver Disease Assessment Protocol

TIPS procedures were conducted using standard techniques [21 (link)]. Serum biochemical assessments (including alanine aminotransferase [ALT], aspartate aminotransferase [AST], albumin [ALB], total bilirubin [T-BIL], blood urea nitrogen [BUN], and serum creatinine [Cr]) were measured using an automatic analyzer (Hitachi 7170A, Hitachi Ltd., Tokyo, Japan). Coagulation function (including prothrombin time [PT], thrombin time [TT], activated partial thromboplastin time [APTT], fibrinogen [Fib], prothrombin activity [PTA], and international normalized ratio [INR]) were measured using a coagulation analyzer (PUN-2048, Perlong Medical Products, Beijing, China). Abdominal ultrasound examination was measured using a Doppler ultrasound diagnostic apparatus (NemioXG, Toshiba, Tokyo, Japan). The stiffness of liver was measured using FibroScan 502 (Echosens, Pairs, France). The severity of liver disease was assessed using traditional Child-Pugh classification as described previously [22 (link), 23 (link)]. T-BIL, ALB, INR, ascites, and HE grade was involved for Child-Pugh scoring.