Transjugular intrahepatic portosystemic shunts for refractory ascites after liver transplantation

M. Abouljoud, A. Yoshida, D. Kim, J. Jerius, J. Arenas, M. Raoufi, K. Brown, D. Moonka

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose. To study the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in the management of refractory ascites after liver transplantation. Between January 1995 and December 2003, 309 primary adult liver transplants were performed. Refractory ascites was defined as active interventions (salt restriction, diuretic use, repeated paracentesis) needed beyond 30 days after transplantation. These patients were managed with TIPS placement. Results. Eight TIPS were placed in 8 patients at a mean of 11.5 months after transplantation (range, 2-36 months). There were 5 males and 3 females, age 54 ± 8.2 years. Hepatitis C was the primary diagnosis in 7 patients and primary biliary cirrhosis in 1. Indications for TIPS included refractory ascites (8), associated variceal bleeding (2), and various degrees of hepatic vein outflow stenosis (3). Seven patients had resolution of ascites and associated findings of portal hypertension, and 1 patient with persistent ascites had severe hepatic vein outflow stenosis and associated hepatitis C in the allograft. Two patients required retransplantation for recurrent hepatitis C. There were 3 deaths: liver failure (1), organ failure after retransplantation (1), and lung cancer 5 months after TIPS (1). Currently, 5 patients are alive without clinical evidence of ascites 9, 13, 15, 24, and 70 months after TIPS. Conclusions. The TIPS device can be used safely and effectively to control refractory ascites after liver transplantation. In the setting of organ dysfunction, these patients should be considered sooner for retransplantation.

Original languageEnglish (US)
Pages (from-to)1248-1250
Number of pages3
JournalTransplantation Proceedings
Volume37
Issue number2
DOIs
StatePublished - Mar 2005

Fingerprint

Transjugular Intrahepatic Portasystemic Shunt
Ascites
Liver Transplantation
Hepatitis C
Hepatic Veins
Pathologic Constriction
Transplantation
Paracentesis
Biliary Liver Cirrhosis
Liver Failure
Portal Hypertension
Diuretics
Allografts
Lung Neoplasms
Salts
Hemorrhage
Transplants
Equipment and Supplies
Liver

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Transjugular intrahepatic portosystemic shunts for refractory ascites after liver transplantation. / Abouljoud, M.; Yoshida, A.; Kim, D.; Jerius, J.; Arenas, J.; Raoufi, M.; Brown, K.; Moonka, D.

In: Transplantation Proceedings, Vol. 37, No. 2, 03.2005, p. 1248-1250.

Research output: Contribution to journalArticle

Abouljoud, M. ; Yoshida, A. ; Kim, D. ; Jerius, J. ; Arenas, J. ; Raoufi, M. ; Brown, K. ; Moonka, D. / Transjugular intrahepatic portosystemic shunts for refractory ascites after liver transplantation. In: Transplantation Proceedings. 2005 ; Vol. 37, No. 2. pp. 1248-1250.
@article{f8e7fe438cde49d9ab71fc617a9c4bcc,
title = "Transjugular intrahepatic portosystemic shunts for refractory ascites after liver transplantation",
abstract = "Purpose. To study the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in the management of refractory ascites after liver transplantation. Between January 1995 and December 2003, 309 primary adult liver transplants were performed. Refractory ascites was defined as active interventions (salt restriction, diuretic use, repeated paracentesis) needed beyond 30 days after transplantation. These patients were managed with TIPS placement. Results. Eight TIPS were placed in 8 patients at a mean of 11.5 months after transplantation (range, 2-36 months). There were 5 males and 3 females, age 54 ± 8.2 years. Hepatitis C was the primary diagnosis in 7 patients and primary biliary cirrhosis in 1. Indications for TIPS included refractory ascites (8), associated variceal bleeding (2), and various degrees of hepatic vein outflow stenosis (3). Seven patients had resolution of ascites and associated findings of portal hypertension, and 1 patient with persistent ascites had severe hepatic vein outflow stenosis and associated hepatitis C in the allograft. Two patients required retransplantation for recurrent hepatitis C. There were 3 deaths: liver failure (1), organ failure after retransplantation (1), and lung cancer 5 months after TIPS (1). Currently, 5 patients are alive without clinical evidence of ascites 9, 13, 15, 24, and 70 months after TIPS. Conclusions. The TIPS device can be used safely and effectively to control refractory ascites after liver transplantation. In the setting of organ dysfunction, these patients should be considered sooner for retransplantation.",
author = "M. Abouljoud and A. Yoshida and D. Kim and J. Jerius and J. Arenas and M. Raoufi and K. Brown and D. Moonka",
year = "2005",
month = "3",
doi = "10.1016/j.transproceed.2004.12.104",
language = "English (US)",
volume = "37",
pages = "1248--1250",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Transjugular intrahepatic portosystemic shunts for refractory ascites after liver transplantation

AU - Abouljoud, M.

AU - Yoshida, A.

AU - Kim, D.

AU - Jerius, J.

AU - Arenas, J.

AU - Raoufi, M.

AU - Brown, K.

AU - Moonka, D.

PY - 2005/3

Y1 - 2005/3

N2 - Purpose. To study the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in the management of refractory ascites after liver transplantation. Between January 1995 and December 2003, 309 primary adult liver transplants were performed. Refractory ascites was defined as active interventions (salt restriction, diuretic use, repeated paracentesis) needed beyond 30 days after transplantation. These patients were managed with TIPS placement. Results. Eight TIPS were placed in 8 patients at a mean of 11.5 months after transplantation (range, 2-36 months). There were 5 males and 3 females, age 54 ± 8.2 years. Hepatitis C was the primary diagnosis in 7 patients and primary biliary cirrhosis in 1. Indications for TIPS included refractory ascites (8), associated variceal bleeding (2), and various degrees of hepatic vein outflow stenosis (3). Seven patients had resolution of ascites and associated findings of portal hypertension, and 1 patient with persistent ascites had severe hepatic vein outflow stenosis and associated hepatitis C in the allograft. Two patients required retransplantation for recurrent hepatitis C. There were 3 deaths: liver failure (1), organ failure after retransplantation (1), and lung cancer 5 months after TIPS (1). Currently, 5 patients are alive without clinical evidence of ascites 9, 13, 15, 24, and 70 months after TIPS. Conclusions. The TIPS device can be used safely and effectively to control refractory ascites after liver transplantation. In the setting of organ dysfunction, these patients should be considered sooner for retransplantation.

AB - Purpose. To study the efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in the management of refractory ascites after liver transplantation. Between January 1995 and December 2003, 309 primary adult liver transplants were performed. Refractory ascites was defined as active interventions (salt restriction, diuretic use, repeated paracentesis) needed beyond 30 days after transplantation. These patients were managed with TIPS placement. Results. Eight TIPS were placed in 8 patients at a mean of 11.5 months after transplantation (range, 2-36 months). There were 5 males and 3 females, age 54 ± 8.2 years. Hepatitis C was the primary diagnosis in 7 patients and primary biliary cirrhosis in 1. Indications for TIPS included refractory ascites (8), associated variceal bleeding (2), and various degrees of hepatic vein outflow stenosis (3). Seven patients had resolution of ascites and associated findings of portal hypertension, and 1 patient with persistent ascites had severe hepatic vein outflow stenosis and associated hepatitis C in the allograft. Two patients required retransplantation for recurrent hepatitis C. There were 3 deaths: liver failure (1), organ failure after retransplantation (1), and lung cancer 5 months after TIPS (1). Currently, 5 patients are alive without clinical evidence of ascites 9, 13, 15, 24, and 70 months after TIPS. Conclusions. The TIPS device can be used safely and effectively to control refractory ascites after liver transplantation. In the setting of organ dysfunction, these patients should be considered sooner for retransplantation.

UR - http://www.scopus.com/inward/record.url?scp=17844371724&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17844371724&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2004.12.104

DO - 10.1016/j.transproceed.2004.12.104

M3 - Article

C2 - 15848685

AN - SCOPUS:17844371724

VL - 37

SP - 1248

EP - 1250

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 2

ER -