Review for 10.1186/s12876-021-01599-7 (2021)

Reviewer’s report
Title: 
Transjugular Intrahepatic Portosystemic Shunt for Hepatic Sinusoidal
Obstruction Syndrome Associated with Consumption of Gynura Segetum
Version: 
1 
Date: 
16 Jul 2020
Reviewer's report:
The case series on TIPS implantation in patients with HSOS after Consumption
of Gynura Segetum is interesting and worth to report to the readership.
However, I would like to ask the authors to revise the manuscript according to
the following comments:
Major comments:
Page 6 Line 11-113: The authors state that an uncovered Stent followed by a
covered Stent were implanted with the uncovered stent being the proximal one.
This is very uncommon. Authors should give reasons for this because partially
covered stents in different lengths are widely available (e.g. GORE VIATORR),
the uncovered part usually being in the portal vein. 
Page 8 line 174 ff: the authors state that asczites was significantly reduced in
five patients. This seems to be a weak endpoint as the amount of aszites is
difficult to measure. A better endpoint would be the reduction (or absence) of
parcentesis procedures after TIPS implantation. 
Some important information about patients characteristics and outcome is
missing: 
Were patients evaluated for transplantation? How many of those patients were
considered candidates for transpantation? 
Can the authors give information about overall and transplant-free survival? Is
there any information on presence of varices and/or history of bleeding? 
Major indication for TIPS seemed to be ascites; authors should give information
about prior treatment (diuretics, necissity and fequency of paracentesis, reponse
to treamtent). 
Did patients recieve anticoagulation prior and after TIPS?
Can authors give informaiton on renal function before and after TIPS?
Was stent patency evaluated in the follow up period?
Table one: authors should give information on Child Pugh and MELD Score
Discussion: 
The use of a percuatneous wire to facilitate transhepatic puncture of the portal
vein may be helpful in some cases but in my opiniion a general advice based on
the presented data cannot be given. Moreover, the advices on placement of the
stent (not to far into the portal vein and the inferior caval vein) apply to all TIPS
procedures, and conclusions from the presented data cannot be drawn on those
technical apsects. 
Minor comments:
Page 5 Line 103: Artis Zee, not Altis Zee
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