Transjugular intrahepatic portosystemic shunts

An update

Barbara Rosado, Patrick Sequeira Kamath

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Transjugular intrahepatic portosystemic shunts (TIPS) have been used in the treatment of complications of portal hypertension. TIPS is used for the control of acute variceal bleeding and for the prevention of vericeal rebleeding when pharmacologic therapy and endoscopic therapy have failed. Patients with refractory ascites with adequate hepatic reserve and renal function who fail to respond to large volume paracentesis may be reasonable candidates for TIPS. Promising indications for TIPS are Budd-Chiari syndrome uncontrolled by medical therapy, severe portal hypertensive gastropathy, refractory hepatic hydrothorax, and hepatorenal syndrome. TIPS cannot be recommended for preoperative portal decompression solely to facilitate liver transplantation. Special care should be taken to insure proper placement of the stent to avoid increasing the technical difficulty of the transplantation procedure. The major limiting factors for TIPS success are shunt dysfunction and hepatic encephalopathy. Because shunt stenosis is the most important cause of recurrent complications of portal hypertension, a surveillance program to monitor shunt patency is mandatory. The MELD score may be useful in predicting post-TIPS survival, and also in counseling patients and their families.

Original languageEnglish (US)
Pages (from-to)207-217
Number of pages11
JournalLiver Transplantation
Volume9
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Transjugular Intrahepatic Portasystemic Shunt
Portal Hypertension
Hydrothorax
Hepatorenal Syndrome
Budd-Chiari Syndrome
Paracentesis
Hepatic Encephalopathy
Liver
Therapeutics
Decompression
Ascites
Liver Transplantation
Stents
Counseling
Pathologic Constriction
Transplantation
Hemorrhage
Kidney
Survival

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Transjugular intrahepatic portosystemic shunts : An update. / Rosado, Barbara; Kamath, Patrick Sequeira.

In: Liver Transplantation, Vol. 9, No. 3, 01.03.2003, p. 207-217.

Research output: Contribution to journalArticle

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