Objectives: To assess transjugular intrahepatic porto- systemic shunt (TIPSS) as an effective bridge be- tween the control of variceal bleeding or refractory ascites and orthotopic liver transplantation (OLTx) and to ...Objectives: To assess transjugular intrahepatic porto- systemic shunt (TIPSS) as an effective bridge be- tween the control of variceal bleeding or refractory ascites and orthotopic liver transplantation (OLTx) and to examine whether TIPSS influences the opera- tive procedures of OLTx. Methods: Five patients treated by TIPSS prior to OLTx were retrospectively reviewed. Results: The patients were followed up for 2-7 months (average 4.2 months) after transplantation. Transplantation was performed at a mean of 9. 6 months (range 0.2-24.7) after TIPSS insertion. In four patients, stents were predominantly intrahepatic and they did not interfere with OLTx. In one pa- tient, the stent extended into the portal vein, requi- ring removal during OLTx by division of the stent with the recipient portal vein. All patients are alive and none has portal vein thrombosis. No difference was observed in operation time, blood transfusion, and the length of hospital stay. Conclusions: TIPSS is an effective bridge to OLTx for the control of variceal hemorrhage or refractory ascites. Our results suggest that TIPSS does not in- crease surgical morbidity or mortality, but optimal TIPSS placement within the liver is emphasized to fa- cilitate subsequent OLTx.展开更多
文摘Objectives: To assess transjugular intrahepatic porto- systemic shunt (TIPSS) as an effective bridge be- tween the control of variceal bleeding or refractory ascites and orthotopic liver transplantation (OLTx) and to examine whether TIPSS influences the opera- tive procedures of OLTx. Methods: Five patients treated by TIPSS prior to OLTx were retrospectively reviewed. Results: The patients were followed up for 2-7 months (average 4.2 months) after transplantation. Transplantation was performed at a mean of 9. 6 months (range 0.2-24.7) after TIPSS insertion. In four patients, stents were predominantly intrahepatic and they did not interfere with OLTx. In one pa- tient, the stent extended into the portal vein, requi- ring removal during OLTx by division of the stent with the recipient portal vein. All patients are alive and none has portal vein thrombosis. No difference was observed in operation time, blood transfusion, and the length of hospital stay. Conclusions: TIPSS is an effective bridge to OLTx for the control of variceal hemorrhage or refractory ascites. Our results suggest that TIPSS does not in- crease surgical morbidity or mortality, but optimal TIPSS placement within the liver is emphasized to fa- cilitate subsequent OLTx.
