title: Use of transjugular intrahepatic portosystemic shunt as a bridge to transplantation in fulminant hepatic failure due to Budd-Chiari syndrome.
abstract: We report a case of fulminant hepatic failure in a 55-yr-old man due to Budd-Chiari syndrome in the setting of polycythemia rubra vera. The patient presented with acute hepatic failure, which rapidly progressed to grade IV hepatic encephalopathy. Placement of a transjugular intrahepatic portosystemic shunt resulted in marked improvement of the encephalopathy and stabilized the liver failure. Subsequently, he underwent successful nonemergent orthotopic liver transplantation. Transjugular intrahepatic portosystemic shunt placement is a safe, effective, therapeutic option to bridge patients with fulminant Budd-Chiari to liver transplantation.
authors.affiliation: Division of Gastroenterology/Hepatology, University of Colorado School of Medicine, Denver 80262, USA.
authors.forename: R
authors.initials: R
authors.lastname: Shrestha
authors.forename: J D
authors.initials: JD
authors.lastname: Durham
authors.forename: M
authors.initials: M
authors.lastname: Wachs
authors.forename: B M
authors.initials: BM
authors.lastname: Bilir
authors.forename: I
authors.initials: I
authors.lastname: Kam
authors.forename: T
authors.initials: T
authors.lastname: Trouillot
authors.forename: G T
authors.initials: GT
authors.lastname: Everson
mesh_terms: D001929:Brain Edema / Q000209:etiology; D006502:Budd-Chiari Syndrome / Q000209:etiology / Q000601:surgery*; D018450:Disease Progression; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000601:surgery*; D006801:Humans; D017114:Liver Failure, Acute / Q000209:etiology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000150:complications; D011170:Portasystemic Shunt, Surgical; D012449:Safety; D016896:Treatment Outcome