title: Transjugular intrahepatic portosystemic shunt for liver transplantation.
abstract: OBJECTIVE
  To assess transjugular intrahepatic portosystemic shunt (TIPSS) as an effective bridge between the control of variceal bleeding or refractory ascites and orthotopic liver transplantation (OLTx) and to examine whether TIPSS influences the operative 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 patient, the stent extended into the portal vein, requiring 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 increase surgical morbidity or mortality, but optimal TIPSS placement within the liver is emphasized to facilitate subsequent OLTx.
authors: Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. gw_vrai@fm365.com
authors: Guang-Wen
authors: GW
authors: Zhou
authors: Wei-Yao
authors: WY
authors: Cai
authors: Hong-Wei
authors: HW
authors: Li
authors: Yue
authors: Y
authors: Zhu
authors: Forrest
authors: F
authors: Dodson
authors: John J
authors: JJ
authors: Fung
mesh_terms: D000328:Adult; D001201:Ascites / Q000601:surgery; D004932:Esophageal and Gastric Varices / Q000150:complications; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012189:Retrospective Studies; D016896:Treatment Outcome