Budd-Chiari Syndrome: Shunt or Transplant?

(1984) Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real-time ultrasonography: a study in 51 Clinical features and prognosis of hepatocellular carcinoma with reference to serum alpha-fetoprotein levels. We have analyzed the indications and results of shunt operation versus orthotopic liver transplantation (OLT) in 22 patients with Budd-Chiari syndrome (BCS). The underlying cause of the syndrome was similar between the two groups and was related to myeloproliferative disorders or the use of birth control, pills in 18 of 22 patients. The results of biopsies of the liver showed centrilobular congestion and necrosis in all candidates who underwent shunting and the presence of fibrosis and cirrhosis in the OLT candidates. The indications for shunts included symptoms related to portal hypertension only and well-preserved synthetic hepatic function.