Changes in peripheral blood lymphocyte subtypes after transjugular intrahepatic portosystemic shunt in patients with decompensated liver cirrhosis: a prospective cohort study

The effects of transjugular intrahepatic portosystemic shunt (TIPS) procedure on the immune system in patients with decompensated liver cirrhosis (LC) remain incompletely understood, therefore this study investigates the short-term changes in peripheral blood lymphocyte subsets following TIPS in these patients. This prospective cohort study included patients with decompensated LC who underwent elective TIPS between January 2024 and December 2024. Percentage and absolute counts of peripheral blood lymphocytes and their subtypes before (most recent preoperative) and after (one week after procedure) TIPS were used for statistical analysis. A total of 68 patients were enrolled. Baseline analyses revealed negative correlations between Child-Pugh, model for end-stage liver disease (MELD), MELD-Na scores, and portacaval pressure gradient (PPG) with absolute counts of CD3+, CD4+, CD19+, CD56 + cells and the CD4+/CD8 + T cell ratio. Post-TIPS, significant increases were observed in the percentages of CD3+ (p < 0.001), CD4+ (p = 0.01), and CD8+ (p = 0.001) T cells, alongside decreases in CD19+ (p < 0.001) B cell percentages and absolute counts of CD3+ (p = 0.03) and CD19+ (p < 0.001) cells. Patients with better liver function and males/elderly individuals tend to exhibit significant short-term immune dysfunction following TIPS.