Transjugular Intrahepatic Porto-Caval Shunt (TIPS) in treatment of portal hypertension in liver transplant recipiens

Ann Transplant. 2008;13(2):42-5.

Abstract

Background: TIPS, as non-operative treatment of portal hypertension allows for safe awaiting liver transplantation for patients otherwise at high risk of hemorrhage from oesophageal varices veins. When endoscopic treatment fails, TIPS is a plausible and less hazardous alternative for surgical porto-systemic shunts. It is of particular importance in patients with liver failure and unacceptable operative risk (group C in Child-Pugh classification).

Material/methods: TIPS was done in 96 patients aged 16-68 years (average 52 years). According to Child-Pugh classification, which documents a stage of liver failure, 60 patients (62%) were in group B, and 36 (38%) in group C. Patients from group C are in most severe condition and at highest operative risk. Postalcoholic and postinflammatory liver cirrhosis is a main cause of portal hypertension.

Results: TIPS was done in 26 patients expecting liver transplantation. Twenty patients had subsequently undergone liver transplantation while remaining 6 are still on the waiting list. In 15 patients stenosis of the shunt was observed within a year. Stenosis was then treated with intervention radiology and implantation of supplemental stents.

Conclusions: TIPS as a non-operative option for treatment of portal hypertension gives a patient an opportunity to await liver transplantation with maximum possible safety. Considering these facts, TIPS is called a bridge to liver transplantation.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Hypertension, Portal / diagnostic imaging
  • Hypertension, Portal / etiology
  • Hypertension, Portal / therapy*
  • Liver Failure / complications
  • Liver Failure / diagnostic imaging
  • Liver Failure / therapy
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Retrospective Studies
  • Stents
  • Treatment Outcome
  • Ultrasonography