[Transjugular intrahepatic portasystemic shunt and liver transplantation].
From the first one hundred consecutive patients treated by transjugular intrahepatic portosystemic shunt (TIPS), 12 subsequently underwent liver transplantation (a mean of 103 +/- 109 days after TIPS). Fourteen TIPS were created in 12 patients, with advanced cirrhosis (Child B = 5, C = 7) and portal hypertension. Seven patients presented either active variceal hemorrhage or refractory variceal bleeding, and 5 cases of refractory ascites. The shunt could be performed in all cases. Two patients experienced rebleeding (one after a shunt obstruction) and were successfully treated by insertion of a second TIPS. A histological study was performed in 10 cases. The shunt was patent in all cases (except in one case previously described), and the endoluminal surface was covered by a connective tissue layer and a new endothelium. We therefore conclude that this method is a safe and effective therapy for complications of portal hypertension, in patients referred for liver transplantation.
Rousseau
H
H
Vinel
J P
JP
Maquin
P
P
Suc
B
B
Bilbao
I
I
Longo
J
J
Fourtanier
G
G
Joffre
F
F
D000328:Adult; D000792:Angiography; D001201:Ascites / Q000209:etiology / Q000601:surgery*; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D011300:Preoperative Care; D012008:Recurrence
Anastomose portosystémique intra-hépatique par voie transjugulaire et transplantation hépatique.