title: Safety and efficacy of TIPS in patients with hemophilia and cirrhosis.
abstract: The prevalence of portal hypertension and its complications is increasing among patients with hemophilia and cirrhosis. The authors evaluated the safety and efficacy of transjugular intrahepatic postosystemic shunt (TIPS) placement in this population. A retrospective analysis was performed of adult patients who underwent TIPS placement at a single center. Four patients with hemophilia and cirrhosis were identified. Outcome measures included technical success and complications, recurrent gastrointestinal hemorrhage, shunt patency, hepatic encephalopathy, ascites control, and mortality. With periprocedural factor VIII supplementation, TIPS were placed in all patients without complications and with improvement in portal hypertension. Outcomes after TIPS placement appear to be comparable to those in patients without hemophilia.
authors.affiliation: Department of Medicine, University of California San Francisco, 505 Parnassus Ave, Box 0628, San Francisco, CA 94143-0628, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Beirne
authors.forename: Allan I
authors.initials: AI
authors.lastname: Bloom
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Bass
authors.forename: Robert K
authors.initials: RK
authors.lastname: Kerlan
authors.forename: Mark W
authors.initials: MW
authors.lastname: Wilson
authors.forename: Roy L
authors.initials: RL
authors.lastname: Gordon
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Laberge
mesh_terms: D000328:Adult; D001201:Ascites / Q000601:surgery*; D003029:Coagulants / Q000627:therapeutic use; D003251:Constriction, Pathologic / Q000209:etiology; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005169:Factor VIII / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D003029:Coagulants; D005169:Factor VIII