Four-Year Survival After Trans-jugular Intrahepatic Porto-systemic Shunt for Veno-occlusive Disease Following Autologous Bone Marrow Transplantation

Abstract

Severe hepatic veno-occlusive disease is still a potentially lethal complication after bone marrow transplantation. We here report the case of a patient who developed liver veno-occlusive disease with severe hemodynamic dysfunction and was successfully treated by means of a trans-jugular intrahepatic portosystemic shunt. After three years, he is still disease-free with a functioning shunt and a normal laboratory liver profile. A trans-jugular intrahepatic portosystemic shunt is a treatment option that has been used in very few patients affected by hepatic veno-occlusive disease; its indications and timing remain to be established.

Hepatic venous outflow obstruction: Three similar syndromes

“…In another clinical trial of defibrotide, complete response was achieved in 22 (55%) of 40 VOD patients [84] . I s o l a t e d c a s e r e p o r t s h ave s h ow n b e n e f i t o f transjugular intrahepatic portosystemic shunt (TIPS) in patients with VOD [85][86][87] . Although it can control portal hypertension, it is not clear whether TIPS can alter the course of the disease.…”