TIPS for veno-occlusive disease: Is the contraindication real?

Senzolo, Marco; Cholongitas, Εvangelos; Patch, David; Burroughs, Andrew K.

doi:10.1002/hep.20773

Cited by 23 publications

(13 citation statements)

References 8 publications

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“…Senzolo et al. have described that a HVPG > 20 mmHg would benefit from TIPS (42). Although the HVPG in case 2 was not significant, the question regarding proper evaluation of the progression of sinusoidal hypertension at that time must have considerable weight.…”

Section: Discussionmentioning

confidence: 99%

Intractable ascites without mechanical vascular obstruction after orthotopic liver transplantation: etiology and clinical outcome of sinusoidal obstruction syndrome

Kitajima¹,

Charlotte²,

Eyraud

et al. 2010

Clinical Transplantation

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Intractable ascites after orthotopic liver transplantation (OLT) is a relatively rare complication. However, it often takes a life threatening course, which requires re-transplantation. In previous studies, several reports gave hepatic sinusoidal obstruction syndrome (SOS) as one of the causes of refractory ascites. However, the detailed etiology of SOS after OLT and its association with clinical consequences remain unclear because there have been few studies to date. We report two recent cases with rapidly progressive refractory ascites associated with SOS, following completely different clinical courses. In case 1, the first episode of acute allograft rejection triggered SOS and subsequent intractable ascites, while the second acute rejection worsened his clinical status. A transjugular intrahepatic portosystemic stent-shunt (TIPS) was placed and this procedure resulted in complete disappearance of ascites and of renal dysfunction. In contrast, refractory ascites in case 2, who had neither rejection nor mechanical outlet obstruction, worsened despite TIPS stent placement, and re-transplantation was necessary. We speculate that the pre-existing diseased liver of the cadaver donor caused this serious complication, necessitating a second graft.

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Section: Discussionmentioning

confidence: 99%

Intractable ascites without mechanical vascular obstruction after orthotopic liver transplantation: etiology and clinical outcome of sinusoidal obstruction syndrome

Kitajima¹,

Charlotte²,

Eyraud

et al. 2010

Clinical Transplantation

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“…If medical treatment is ineffective, prompt transjugular intrahepatic portosystemic stent‐shunt placement is recommended as a potentially life‐saving procedure for patients with ongoing decline in liver function following SIRT. This recommendation is based on largely anecdotal experience with REILD and the collective published literature in life‐threatening clinical syndromes resulting from sinusoidal congestion …”

Section: Liver Complicationsmentioning

confidence: 99%

“…This recommendation is based on largely anecdotal experience with REILD (27) and the collective published literature in life-threatening clinical syndromes resulting from sinusoidal congestion. (60,61)…”

Section: Diagnostic Workup For Suspected Reildmentioning

confidence: 99%

Prevention and treatment of complications of selective internal radiation therapy: Expert guidance and systematic review

et al. 2017

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Selective internal radiation therapy (or radioembolization) by intra-arterial injection of radioactive yttrium-90-loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high-dose beta-radiation penetrates an average of only 2.5 mm from the source, thus limiting its effects to the site of delivery. However, the off-target diversion of yttrium-90 microspheres to tissues other than the tumor may lead to complications. The most prominent of these complications include radiation gastritis and gastrointestinal ulcers, cholecystitis, radiation pneumonitis, and radioembolization-induced liver disease, which may occur despite careful pretreatment planning. Thus, selective internal radiation therapy demands an expert multidisciplinary team approach in order to provide comprehensive care for patients. This review provides recommendations to multidisciplinary teams on the optimal medical processes in order to ensure the safe delivery of selective internal radiation therapy. Based on the best available published evidence and expert opinion, we recommend the most appropriate strategies for the prevention, early diagnosis, and management of potential radiation injury to the liver and to other organs. (Hepatology 2017;66:969-982).

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“…All but three (2 with previous liver and 1 with previous kidney transplantation) had bone marrow transplantation [58] . The most common causes of death usually occurring within 1 to 3 wk following diagnosis were multi organ failure (MOF), sepsis and haemorrhage, due to underlying haematological disease.…”

Section: Treatmentmentioning

confidence: 99%