Transjugular intrahepatic portosystemic shunt in adult liver recipient with delayed graft function.
BACKGROUND
Transjugular intrahepatic portosystemic shunt (TIPS) has become an effective treatment for the complications of portal hypertension. We assessed the feasibility and outcome of TIPS in liver transplant recipients who developed delayed graft function (DGF) with portal hypertension.


METHODS
From June 2003 to June 2004, 80 cadaveric orthotopic liver transplantation (OLTx) have been performed at our institution. Five patients (6.25%) developed DGF with hyperbilirubinemia and ascites with severe portal hypertension and were treated with TIPS placement (in the 6-month time period from the transplantation).


RESULTS
There were no complications related to the procedure. No episodes of encephalopathy were seen. Four patients had better control of the ascites. In one case, we observed complete recovery of the transplanted liver with normalization of the liver function test. Three patients underwent retransplantation (within 7 days from the TIPS), whereas 1 is still on the list 6 months after TIPS placement with recurrent episodes of ascites.


CONCLUSIONS
In our preliminary series, TIPS reduced dramatically the portosystemic gradient and improved clinical conditions. The results were negatively affected by the fact that the transplanted liver did not recover its function.
Vasta
F
F
Department of Surgery, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione IsMeTT-UPMC Italy, Palermo, Italy. fvasta@ismett.edu
Luca
A
A
Miraglia
R
R
Spada
M
M
Gruttadauria
S
S
Verzaro
R
R
Cintorino
D
D
Mandala
L
L
Arcadipane
A
A
Vizzini
G
G
Gridelli
B
B
D000328:Adult; D002102:Cadaver; D006801:Humans; D006932:Hyperbilirubinemia / Q000453:epidemiology / Q000601:surgery; D006975:Hypertension, Portal / Q000453:epidemiology / Q000601:surgery; D007601:Jugular Veins; D016031:Liver Transplantation / Q000379:methods* / Q000502:physiology; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D011183:Postoperative Complications / Q000145:classification / Q000601:surgery; D012189:Retrospective Studies; D014019:Tissue Donors