Transjugular Intrahepatic Portosystemic Shunt in patients after orthotopic liver transplantation (OLTx) due to life threatening gastrointestinal hemorrhage. A single-center experience based on three cases and literature review
Journal Title: Polish Journal of Surgery - Year 2019, Vol 91, Issue 2
Abstract
Background: Transjugular intrahepatic portosystemic shunt system (TIPS) is a well-recognized method of treatment of symptomatic portal hypertension in patients awaiting liver transplantation. The effectiveness of TIPS treatment in patients after liver transplantation is still not fully established. Indications for both groups of patients, with and without liver graft, are similar and include bleeding from gastrointestinal varices, ascites, pleural effusion, and Budd-Chiari syndrome. Feasibility of TIPS in emergency treatment in patients after OLTx due to life-threatening hemorrhage is not well described. Materials and methods: Patients, after OLTx performed using classical, non-piggyback technique had severe hemorrhages from gastrointestinal varices due to lost graft function. Patients were in an unstable condition, required blood transfusions on admittance and monitoring in Intensive Care Unit. TIPS were implanted urgently, after unsuccessful endoscopic treatment, as a life-saving procedure. Results: In all cases, the procedure was successfully completed. The bleeding did not reoccur during the postoperative course. Conclusion: TIPS procedure appears to be justified as a bridge to a planned retransplantation, or as a treatment of choice in patients disqualified from retransplantation. Emergency performance of the TIPS procedure as a treatment for acute variceal bleeding should still be considered individually for each patient and only as a procedure leading to further treatment.<br/><br/>
Authors and Affiliations
Magdalena Januszewicz, Inga Włodarczyk-Pruszyńska, Krzysztof Milczarek, Katarzyna Rowińska-Berman, Krzysztof Zieniewicz, Tadeusz Wróblewski, Olgierd Rowiński
Keywords
Related Articles
- EP ID EP420596
- DOI 10.5604/01.3001.0012.7791
- Views 107
- Downloads 0
Czy ureazowy test oddechowy (UBT) może zastąpić szybki test ureazowy (RUT)?
Wstęp: Helicobacter pylori (Hp) jest zaliczany przez International Agency for Research on Cancer (IARC) do pierwszej grupy karcynogenów. Wpływ bakterii na rozwój raka żołądka został potwierdzony w wielu badaniach. Wniose...
Upper limb ischaemia after formation of dialysis fistula
Limb ischaemia caused by formation of dialysis fistula is rare but serious complication. The severity of symptoms may vary but rest pains and necrotic lesions are observed in most advance cases. In these patients differe...
Coccygodynia – patogeneza, diagnostyka i terapia. Przegląd piśmiennictwa
Coccygodynia to problem dotyczący 1% populacji cierpiącej z powodu dolegliwości narządu ruchu. Ból ten kojarzony jest często przez pacjentów z urazem, upadkiem na kość ogonową, długą jazdą na rowerze, czy też – u kobiet...
Lateral and median cysts of the neck
Splenic artery pseudoaneurysm rupture into a pancreatic pseudocyst with its subsequent perforation as the cause of a massive intra-abdominal bleeding – case report
Pseudocysts account for approximately 70% of all cystic lesions of the pancreas. One of the most dangerous complications of pancreatic pseudocysts is bleeding into the cystic lumen; the most common cause of the bleeding...