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Hepatic encephalopathy in a liver transplant recipient with stable liver function
Author(s) -
Arab Juan Pablo,
Meneses Luis,
Pérez Rosa M.,
Arrese Marco,
Benítez Carlos
Publication year - 2013
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.26298
Subject(s) - medicine , hepatic encephalopathy , liver transplantation , portal vein thrombosis , cirrhosis , portosystemic shunt , encephalopathy , stenosis , transjugular intrahepatic portosystemic shunt , liver function , portal hypertension , asymptomatic , hepatocellular carcinoma , lactulose , radiology , gastroenterology , transplantation , liver disease , surgery
Postshunt hepatic encephalopathy after liver transplantation (LT) is an infrequent condition and is commonly associated with portal occlusion or stenosis and the presence of a patent portosystemic shunt. Portal vein stenosis (PVS) or thrombosis (PVT) are uncommon complications after LT. The overall frequency of both complications is reported to be less than 3%. When PVS or PVT develop early after LT, the occlusion of the portal vein can have catastrophic consequences to the graft including acute liver failure and graft loss. Late PVT/PVS are asymptomatic in approximately 50% of the cases and mainly diagnosed by a routine ultrasound. Symptomatic postshunt hepatic encephalopathy (HE) is a very infrequent condition after LT that has been scarcely reported in the literature. We present here the case of a liver recipient with normal graft function who presented with hepatic encephalopathy 3 months after LT with stable liver function but a severe portal stenosis and the presence of a spontaneous portosystemic shunt whose successful endovascular treatment was followed by the complete resolution of the HE.