Semin intervent Radiol 2005; 22(4): 329-333
DOI: 10.1055/s-2005-925559
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Transjugular Intrahepatic Portosystemic Shunts in Liver Transplant Recipients: Technical Considerations and Review of the Literature

Nilesh H. Patel1 , Jay Patel1 , George Behrens1 , Anthony Savo2
  • 1Department of Radiology, Rush University Medical Center, Chicago, Illinois
  • 2Department of Surgery, Rush University Medical Center, Chicago, Illinois
Further Information

Publication History

Publication Date:
03 January 2006 (online)

ABSTRACT

Transjugular intrahepatic portosystemic shunt (TIPS) is an accepted therapeutic option for the treatment of complications of portal hypertension, such as refractory variceal bleeding, refractory ascites, refractory hepatic hydrothorax and Budd-Chiari syndrome, in cirrhotic livers. However, portal hypertension is uncommon after liver transplantation, and when it occurs, it has been related to hepatic vein outflow obstruction, small liver donor size, rejection, or recurrence of the original disease. There are few reports in the literature addressing TIPS experience in liver transplant patients. This review will address the published experience of TIPS procedures in liver transplant patients, including indications, technical issues, complications, and outcomes.

REFERENCES

  • 1 Everhart J E, Lombardero M, Detre K M et al.. Increased waiting time for liver transplantation results in higher mortality.  Transplantation. 1997;  64 1300-1306
  • 2 Wright T L, Donegan E, Hsu H H et al.. Recurrent and acquired hepatitis C viral infection in liver transplant recipients.  Gastroenterology. 1992;  103 317-322
  • 3 Ascher N L, Lake J R, Emond J, Roberts J. Liver transplantation for hepatitis C virus-related cirrhosis.  Hepatology. 1994;  20 24S-27S
  • 4 Adetiloye V A, John P R. Intervention for pleural effusions and ascites following liver transplantation.  Pediatr Radiol. 1998;  28 539-543
  • 5 Herzog D, Martin S, Lallier M, Alvarez F. Ascites after orthotopic liver transplantation in children.  Pediatr Transplant. 2005;  9 74-79
  • 6 Cirera I, Navasa M, Rimola A et al.. Ascites after liver transplantation.  Liver Transpl. 2000;  6 157-162
  • 7 Mabrut J Y, de la Roche E, Adham M, Ducerf C, Baulieux J. [Peritoneovenous diversion using the LeVeen shunt in the treatment of refractory ascites after liver transplantation].  Ann Chir. 1998;  52 612-617
  • 8 Hadengue A, Lebrec D, Moreau R et al.. Persistence of systemic and splanchnic hyperkinetic circulation in liver transplant patients.  Hepatology. 1993;  17 175-178
  • 9 Bilbao J I, Herrero J I, Martinez-Cuesta A et al.. Ascites due to anastomotic stenosis after liver transplantation using the piggyback technique: treatment with endovascular prosthesis.  Cardiovasc Intervent Radiol. 2000;  23 149-151
  • 10 Mizuno S, Yokoi H, Yamagiwa K et al.. Outflow block secondary to stenosis of the inferior vena cava following living-donor liver transplantation?.  Clin Transplant. 2005;  19 215-219
  • 11 Borsa J J, Daly C P, Fontaine A B et al.. Treatment of inferior vena cava anastomotic stenoses with the Wallstent endoprosthesis after orthotopic liver transplantation.  J Vasc Interv Radiol. 1999;  10 17-22
  • 12 Lerut J P, Goffette P, Molle G et al.. Transjugular intrahepatic portosystemic shunt after adult liver transplantation: experience in eight patients.  Transplantation. 1999;  68 379-384
  • 13 Amesur N B, Zajko A B, Orons P D, Sammon J K, Casavilla F A. Transjugular intrahepatic portosystemic shunt in patients who have undergone liver transplantation.  J Vasc Interv Radiol. 1999;  10 569-573
  • 14 Van Ha T G, Funaki B S, Ehrhardt J et al.. Transjugular intrahepatic portosystemic shunt placement in liver transplant recipients: experiences with pediatric and adult patients.  AJR Am J Roentgenol. 2005;  184 920-925
  • 15 Richard III H M, Cooper J M, Ahn J, Silberzweig J E, Emre S H, Mitty H A. Transjugular intrahepatic portosystemic shunts in the management of Budd-Chiari syndrome in the liver transplant patient with intractable ascites: anatomic considerations.  J Vasc Interv Radiol. 1998;  9 137-140
  • 16 Wilson M W, Gordon R L, LaBerge J M et al.. Liver transplantation complicated by malpositioned transjugular intrahepatic portosystemic shunts.  J Vasc Interv Radiol. 1995;  6 695-699
  • 17 Farney A C, Gamboa P, Payne W D, Gruessner R W. Donor iliac vein interposition during liver transplantation in a patient with a migrated transjugular intrahepatic portosystemic shunt.  Transplantation. 1998;  65 572-574
  • 18 Maleux G, Nevens F, Wilmer A et al.. Early and long-term clinical and radiological follow-up results of expanded-polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunt procedures.  Eur Radiol. 2004;  14 1842-1850
  • 19 Rossle M, Haag K, Ochs A et al.. The transjugular intrahepatic portosystemic stent-shunt procedure for variceal bleeding.  N Engl J Med. 1994;  330 165-171
  • 20 Ochs A, Rossle M, Haag K et al.. The transjugular intrahepatic portosystemic stent-shunt procedure for refractory ascites.  N Engl J Med. 1995;  332 1192-1197
  • 21 Rossle M. The transjugular intrahepatic portosystemic shunt.  J Hepatol. 1996;  25 224-231

Nilesh H PatelM.D. 

Department of Radiology, Rush University Medical Center

1653 West Congress Parkway, Chicago, IL, 60612

    >