Reviewer's report
Title:Budd-Chiari Syndrome: Long term success via hepatic decompression
using transjugular intrahepatic porto-systemic shunt
Version: 1Date:2 October 2009
Reviewer: Juan Gonzalez-Abraldes
Reviewer's report:
This study reports a single center experience over 20 years with patients with
Budd-Chiari Syndrome. The center has a special experience in TIPS (since TIPS
was developed there). They gathered 20 patients. Among them 13 underwent
TIPS and 4 liver transplantation.
Major Compulsory Revisions
1. The recent study by Darwish Murad S (Ann Intern Med. 2009 Aug
4;151(3):167-75), which is the only prospective study on Budd-Chiari, should be
quoted and commented. A relevant finding of that study is that almost 50% of the
patients can be managed conservatively.
2. The authors should discuss the fact that they have not used covered stents.
This is not unexpected, since the availability of these stents is relatively recent.
The use of covered stents have been associated with a lower rate of dysfunction,
both in patients with cirrhosis (Bureau et al, Gastroenterology 2004) and
Budd-Chiari syndrome (Hernández-Guerra et al, Hepatology 2004)
3. Table 1: 3 patients (those that did not had TIPS or liver transplantation) are not
reported. They should be added to the table
Minor Essential Revisions
4. The authors should discuss that some patients previously considered of
unknown etiology can be currently diagnosed of myeloproliferative syndromes by
the analysis of JAK2 mutation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Reviewer's report
Title:Budd-Chiari Syndrome: Long term success via hepatic decompression
using transjugular intrahepatic porto-systemic shunt
Version: 1Date:2 October 2009
Reviewer: Juan Gonzalez-Abraldes
Reviewer's report:
This study reports a single center experience over 20 years with patients with
Budd-Chiari Syndrome. The center has a special experience in TIPS (since TIPS
was developed there). They gathered 20 patients. Among them 13 underwent
TIPS and 4 liver transplantation.
Major Compulsory Revisions
1. The recent study by Darwish Murad S (Ann Intern Med. 2009 Aug
4;151(3):167-75), which is the only prospective study on Budd-Chiari, should be
quoted and commented. A relevant finding of that study is that almost 50% of the
patients can be managed conservatively.
2. The authors should discuss the fact that they have not used covered stents.
This is not unexpected, since the availability of these stents is relatively recent.
The use of covered stents have been associated with a lower rate of dysfunction,
both in patients with cirrhosis (Bureau et al, Gastroenterology 2004) and
Budd-Chiari syndrome (Hernández-Guerra et al, Hepatology 2004)
3. Table 1: 3 patients (those that did not had TIPS or liver transplantation) are not
reported. They should be added to the table
Minor Essential Revisions
4. The authors should discuss that some patients previously considered of
unknown etiology can be currently diagnosed of myeloproliferative syndromes by
the analysis of JAK2 mutation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
Please review this paper.
user
Reviewer's report
Title:Budd-Chiari Syndrome: Long term success via hepatic decompression
using transjugular intrahepatic porto-systemic shunt
Version: 1Date:2 October 2009
Reviewer: Juan Gonzalez-Abraldes
Reviewer's report:
This study reports a single center experience over 20 years with patients with
Budd-Chiari Syndrome. The center has a special experience in TIPS (since TIPS
was developed there). They gathered 20 patients. Among them 13 underwent
TIPS and 4 liver transplantation.
Major Compulsory Revisions
1. The recent study by Darwish Murad S (Ann Intern Med. 2009 Aug
4;151(3):167-75), which is the only prospective study on Budd-Chiari, should be
quoted and commented. A relevant finding of that study is that almost 50% of the
patients can be managed conservatively.
2. The authors should discuss the fact that they have not used covered stents.
This is not unexpected, since the availability of these stents is relatively recent.
The use of covered stents have been associated with a lower rate of dysfunction,
both in patients with cirrhosis (Bureau et al, Gastroenterology 2004) and
Budd-Chiari syndrome (Hernández-Guerra et al, Hepatology 2004)
3. Table 1: 3 patients (those that did not had TIPS or liver transplantation) are not
reported. They should be added to the table
Minor Essential Revisions
4. The authors should discuss that some patients previously considered of
unknown etiology can be currently diagnosed of myeloproliferative syndromes by
the analysis of JAK2 mutation.
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests'
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