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Transjugular intrahepatic portosystemic shunt for hepatitis C virus‐related portal hypertension after liver transplantation
Author(s) -
Ghinolfi Davide,
De Simone Paolo,
Catalano Gabriele,
Petruccelli Stefania,
Coletti Laura,
Carrai Paola,
Marti Josep,
Tincani Giovanni,
Cicorelli Antonio,
Cioni Roberto,
Filipponi Franco
Publication year - 2012
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2011.01595.x
Subject(s) - medicine , hydrothorax , transjugular intrahepatic portosystemic shunt , ascites , gastroenterology , liver transplantation , portal hypertension , transplantation , hepatitis c virus , surgery , hepatitis c , cirrhosis , virus , virology
Ghinolfi D, De Simone P, Catalano G, Petruccelli S, Coletti L, Carrai P, Marti J, Tincani G, Cicorelli A, Cioni R, Filipponi F. Transjugular intrahepatic portosystemic shunt for hepatitis C virus‐related portal hypertension after liver transplantation. Abstract: This is a single center retrospective review of 19 consecutive liver transplant (LT) patients with hepatitis C virus (HCV)‐related graft recurrent hepatitis who underwent transjugular intrahepatic portosystemic shunt (TIPS) at a median interval of 21 months (range: 5–50) from LT. Indications were refractory ascites in 11 patients (57.9%), hydrothorax in six (31.6%), and both in two (10.5%). TIPS was successful in 94.7% of cases (18/19) with only one procedure‐related mortality (5.3%) owing to sepsis on day 35. At a median follow‐up of 23 months (range: one month–nine yr), TIPS allowed for symptoms resolution in 16 patients (84.2%), with ascites resolving in all cases and hydrothorax persisting in 2. Post‐TIPS patient survival at six months, one yr, and three yr was 84.2%, 73.7%, and 56.8%, respectively. We compared these results with a control group of 29 patients with HCV recurrence but without unresponsive ascites or hydrothorax. Patients in the control group had better survival than patients undergoing TIPS placement. However, survival of TIPS patients with a MELD score lower than or equal to 12 was similar to that of the control group. We conclude that TIPS may be used to treat complications secondary to HCV.