title: Transjugular intrahepatic portosystemic shunt for the treatment of sinusoidal obstruction syndrome in a liver transplant recipient and review of the literature.
abstract: Sinusoidal obstruction syndrome (SOS) is a rare, life-threatening clinical syndrome resulting from sinusoidal congestion, and it is characterized by hepatomegaly, ascites, weight gain, and jaundice. The frequency of this condition after liver transplantation (LT) is low, but when SOS is severe and refractory to medical therapy, the ultimate solution is retransplantation. We describe a patient with SOS after LT who was successfully treated by the placement of a transjugular intrahepatic portosystemic shunt (TIPS). Although information on this approach is scarce because of the low incidence of SOS in LT patients, we review the available literature on treating this condition with a TIPS. On the basis of the reported information and our patient's outcome, we suggest that prompt TIPS placement can be considered for SOS when medical treatment fails. Nonetheless, a formal assessment and prospective studies are needed to confidently indicate TIPS placement in this situation.
authors.affiliation: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d' Hebron, Institut de Recerca, Barcelona, Spain. icampos@vhebron.net
authors.forename: Isabel
authors.initials: I
authors.lastname: Campos-Varela
authors.forename: Lluís
authors.initials: L
authors.lastname: Castells
authors.forename: Cristina
authors.initials: C
authors.lastname: Dopazo
authors.forename: Mercedes
authors.initials: M
authors.lastname: Pérez-Lafuente
authors.forename: Helena
authors.initials: H
authors.lastname: Allende
authors.forename: Oscar
authors.initials: O
authors.lastname: Len
authors.forename: Lluís
authors.initials: L
authors.lastname: Llopart
authors.forename: Victor
authors.initials: V
authors.lastname: Vargas
authors.forename: Ramón
authors.initials: R
authors.lastname: Charco
mesh_terms: D001201:Ascites / Q000209:etiology / Q000601:surgery; D001706:Biopsy; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D015641:Radiography, Interventional; D016896:Treatment Outcome