Grant: Project Grant

A liver bypass procedure using a metallic stent, called a TIPS, is needed to treat water accumulation in the abdomen of patients with advanced liver disease. Unfortunately, this procedure can cause confusion in 50% of patients. This confusion leads to serious problems including frequent hospitalizations, worse quality of life and death. There are currently no treatments to prevent this confusion from happening. Poor nutrition is commonly seen in patients who need a TIPS procedure. It is also associated with more confusion and death after TIPS. We suspect that improving the nutrition of patient undergoing TIPS will reduce post-TIPS confusion. Our study aims to find out if a clinical trial improving the nutrition of patients undergoing TIPS to prevent confusion is feasible. We think that nutrition will reduce inflammation, and help build muscle, ultimately reducing confusion. In our study, we plan to recruit 50 participants. Half of participants will regularly meet with a dietitian while the other half will receive standard of care for a total of 7 months. For primary feasibility objective, we will assess if we can recruit at least 3 participants at 6 sites per month, for a total of 50 participants. We believe that our approach could be better than current practice and lead to important changes in how we manage poor nutrition in patients going for a TIPS. We will see if our new approach would help save the system and patients money by reducing hospitalizations and focusing on preventative care. We will also identify biomarkers to predict who will develop confusion. This will ultimately lead to better patient care.