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TIPS liver cirrhosis

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https://www.readbyqxmd.com/read/29110825/long-term-outlook-in-biliary-atresia
#1
Arun Kelay, Mark Davenport
The oldest survivors from the Kasai portoenterostomy originate in Sendai, Japan and are approaching their 60th birthday. These represent the tip of an expanding cohort of adults born with this previously fatal condition. Increasingly transition to adult-biased hepatologists and physicians will be the expectation of many with this condition. However unlike their usual patients with alcohol, drugs, virally mediated liver disease these are different with different expectations of health and quality of life. Cure is not on the cards for most of these and they survive still with impaired bile flow and increased liver fibrosis and cirrhosis with the threat of cholangitis and portal hypertension still apparent...
October 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29105936/circulating-cxcl10-in-cirrhotic-portal-hypertension-might-reflect-systemic-inflammation-and-predict-aclf-and-mortality
#2
Jennifer M Lehmann, Karina Claus, Christian Jansen, Alessandra Pohlmann, Robert Schierwagen, Carsten Meyer, Daniel Thomas, Steffen Manekeller, Joan Claria, Christian P Strassburg, Christian Trautwein, Hermann E Wasmuth, Marie-Luise Berres, Jonel Trebicka
BACKGROUND & AIMS: CXCR% ligands play an important role in hepatic injury, inflammation and fibrosis. While CXCL9 and CXCL11 are associated with survival in patients receiving transjugular intrahepatic portosystemic shunt (TIPS), the role of CXCL10 in severe portal hypertension remains unknown. METHODS: A total of 89 cirrhotic patients were analysed. CXCL10 protein levels were measured in portal and hepatic blood at TIPS insertion and 2 weeks later in 24 patients...
November 6, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29102862/reno-portal-shunt-for-liver-transplant-an-alternative-inflow-for-recipients-with-grade-iii-iv-portal-vein-thrombosis-tips-for-a-better-outcome
#3
Mustafa Nazzal, Yifei Sun, Obi Okoye, Laurence Diggs, Neil Evans, Tamara Osborn, Kambiz Etesami, Chintalapati Varma
INTRODUCTION: Portal vein thrombosis (PVT) poses an extremely difficult problem in cirrhotic patients who are in need of a liver transplant. The prevalence of PVT in patients with cirrhosis ranges from 0.6% to 26% Nery et al. (2015) [1]. The presence of PVT is associated with more technically difficult liver transplant and in certain cases can be a contraindication to liver transplant. The only option for these patients with extensive PVT would be a multi-visceral transplant, the later unfortunately has a much higher morbidity and mortality compared to liver only transplant Smith et al...
October 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29074483/transjugular-intrahepatic-portosystemic-shunt-impact-on-systemic-haemodynamics-and-renal-and-cardiac-function-in-patients-with-cirrhosis
#4
Troels Malte Busk, Flemming Bendtsen, Jørgen Hjelm Poulsen, Jens Otto Clemmesen, Fin Stolze Larsen, Jens Peter Goetze, Jens Schmidt Iversen, Magnus Thorsten Jensen, Rasmus Møgelvang, Erling Bjerregaard Pedersen, Jesper Noergaard Bech, Søren Møller
BACKGROUND AND AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension and possibly increases central blood volume (CBV). Moreover, renal function often improves; however, its effects on cardiac function are unclear. The aims of our study were to examine the effects of TIPS on hemodynamics and renal and cardiac function in patients with cirrhosis. METHODS: In 25 cirrhotic patients, we analyzed systemic, cardiac, and splanchnic hemodynamics by catheterization of the liver veins and right heart chambers before and 1 week after TIPS...
October 26, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29064029/the-portal-hypertension-syndrome-etiology-classification-relevance-and-animal-models
#5
REVIEW
Jaime Bosch, Yasuko Iwakiri
BACKGROUND: Portal hypertension is a key complication of portal hypertension, which is responsible for the development of varices, ascites, bleeding, and hepatic encephalopathy, which, in turn, cause a high mortality and requirement for liver transplantation. AIM: This review deals with the present day state-of-the-art preventative treatments of portal hypertension in cirrhosis according to disease stage. Two main disease stages are considered, compensated and decompensated cirrhosis, the first having good prognosis and being mostly asymptomatic, and the second being heralded by the appearance of bleeding or non-bleeding complications of portal hypertension...
October 24, 2017: Hepatology International
https://www.readbyqxmd.com/read/29059469/fat-free-muscle-mass-in-magnetic-resonance-imaging-predicts-acute-on-chronic-liver-failure-and-survival-in-decompensated-cirrhosis
#6
Michael Praktiknjo, Marius Book, Julian Luetkens, Alessandra Pohlmann, Carsten Meyer, Daniel Thomas, Christian Jansen, Andreas Feist, Johannes Chang, Jochen Grimm, Jennifer Lehmann, Christian P Strassburg, Juan Gonzalez Abraldes, Guido Kukuk, Jonel Trebicka
BACKGROUND: Muscle mass seems to be a prognostic marker in patients with liver cirrhosis. However, reported methods to quantify muscle mass are heterogeneous, consented cut-off values are missing and most studies used computed tomography (CT). This study evaluated fat-free muscle area as a marker of sarcopenia using magnetic resonance imaging (MRI) in decompensated cirrhotic patients with transjugular intrahepatic portosystemic shunt (TIPS). METHODS: The total erector spinae muscle area and the intramuscular fat tissue area were measured and subtracted to calculate the fat-free muscle area (FFMA) in 116 cirrhotic patients with TIPS and MRI...
October 23, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29051188/rapid-change-of-liver-stiffness-after-variceal-ligation-and-tips-implantation
#7
Felix Piecha, Daniel Paech, Janina Sollors, Helmut-Karl Seitz, Martin Rössle, Vanessa Rausch, Sebastian Mueller
Liver stiffness (LS) as measured by transient elastography is widely used to screen for liver fibrosis. However, LS also increases in response to pressure changes like congestion but no data on portal pressure are available. We here study the effect of rapid portal pressure changes on LS. Therefore, LS was assessed directly prior and after ligation of esophageal varices (n=11) as well as TIPS implantation in patients with established cirrhosis (n=14). Additionally, we retrospectively analyzed changes in LS and variceal size in patients with sequential gastroscopic monitoring and LS measurements (n=14)...
October 19, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29050854/pretransplantation-portal-vein-recanalization-and-transjugular-intrahepatic-portosystemic-shunt-creation-for-chronic-portal-vein-thrombosis-final-analysis-of-a-61-patient-cohort
#8
Bartley Thornburg, Kush Desai, Ryan Hickey, Elias Hohlastos, Laura Kulik, Daniel Ganger, Talia Baker, Michael Abecassis, Juan C Caicedo, Daniela Ladner, Jonathan Fryer, Ahsun Riaz, Robert J Lewandowski, Riad Salem
PURPOSE: To report the final analysis of the safety and efficacy of portal vein (PV) recanalization (PVR) and transjugular intrahepatic portosystemic shunt (TIPS) creation (PVR-TIPS) in patients with PV thrombosis (PVT) in need of liver transplantation. MATERIALS AND METHODS: Sixty-one patients with cirrhosis and PVT underwent PVR-TIPS to improve transplantation candidacy. Median patient age was 58 years (range, 22-75 y), and median pre-TIPS Model for End-Stage Liver Disease score was 14 (range, 7-42)...
October 17, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29049129/transjugular-intrahepatic-portosystemic-shunt-placement-before-abdominal-intervention-in-cirrhotic-patients-with-portal-hypertension-lessons-from-a-pilot-study
#9
Nadim Fares, Marie-Angèle Robic, Jean-Marie Péron, Fabrice Muscari, Philippe Otal, Bertrand Suc, Jean-Pierre Vinel, Christophe Bureau
BACKGROUND: Abdominal interventions are usually contraindicated in patients with cirrhosis and portal hypertension because of increased morbidity and mortality. Decreasing portal pressure with transjugular intrahepatic portosystemic shunt (TIPS) may improve patient outcomes. We report our experience with patients treated by neoadjuvant TIPS to identify those who would most benefit from this two-step procedure. PATIENTS AND METHODS: All patients treated by dedicated neoadjuvant TIPS between 2005 and March 2013 in two tertiary referral hospitals were included...
October 18, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29043403/hepatic-morphology-abnormalities-beyond-cirrhosis
#10
REVIEW
Giuseppe Mamone, Kelvin Cortis, Aquilina Sarah, Settimo Caruso, Roberto Miraglia
The diagnosis of cirrhosis can be reached on the basis of established hepatic morphological changes. However, some other conditions can mimic cirrhosis. The aim of this pictorial essay is to review the CT and MRI appearances of hepatic morphology abnormalities in the cirrhotic liver and other diseases, describing pathologic conditions that can mimic cirrhosis, with useful tips for the differential diagnosis. Mimickers of cirrhosis include congenital hepatic fibrosis, Caroli disease, Budd-Chiari Syndrome, hepatoportal sclerosis, cavernous transformation of the portal vein, pseudocirrhosis from metastatic disease, acute liver failure, post-therapeutic morphologic changes in the liver, and infective conditions including schistosomiasis and oriental cholangiohepatitis...
October 17, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28990812/transjugular-intrahepatic-portosystemic-shunt-treatment-of-variceal-bleeding-in-an-unselected-patient-population
#11
K Rosenqvist, R Sheikhi, R Nyman, F Rorsman, P Sangfelt, C Ebeling Barbier
OBJECTIVE: To evaluate transjugular intrahepatic portosystemic shunt (TIPS) in variceal bleeding in a clinical setting. MATERIALS AND METHODS: Retrospective review of 131 patients (116 with liver cirrhosis) treated with TIPS with covered stent grafts in a single centre from 2002 to 2016. RESULTS: Survival at 1 and 2 years was 70% and 57% in patents with, and 100% at 2 years in patients without liver cirrhosis, respectively. A high Child-Pugh score and severe hepatic encephalopathy (HE) within 12 months post-TIPS were related to increased mortality...
October 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28925475/percutaneous-implant-of-denver-peritoneo-venous-shunt-for-treatment-of-refractory-ascites-a-single-center-retrospective-study
#12
M Piccirillo, L Rinaldi, M Leongito, A Amore, A Crispo, V Granata, P Aprea, F Izzo
OBJECTIVE: Refractory ascites is defined as a lack of response to high doses of diuretics or the development of diuretic related side effects, which compel the patient to discontinue the diuretic treatment. Current therapeutic strategies include repeated large-volume paracentesis and transjugular intrahepatic portosystemic shunts (TIPS). Peritoneovenous shunt (Denver shunt) should be considered for patients with refractory ascites who are not candidates for paracentesis or TIPS. This study presents our case series in the implant of Denver peritoneovenous shunt...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28922103/budd-chiari-syndrome
#13
Tomáš Grus, Lukáš Lambert, Gabriela Grusová, Rohan Banerjee, Andrea Burgetová
Budd-Chiari syndrome (BCS) is a rare disease with an incidence of 0.1 to 10 per million inhabitants a year caused by impaired venous outflow from the liver mostly at the level of hepatic veins and inferior vena cava. Etiological factors include hypercoagulable conditions, myeloprolipherative diseases, anatomical variability of the inferior vena cava, and environmental conditions. Survival rates in treated patients range from 42 to 100% depending on the etiology and the presence of risk factors including parameters of Child-Pugh score, sodium and creatinine plasma levels, and the choice of treatment...
2017: Prague Medical Report
https://www.readbyqxmd.com/read/28918131/cirrhotic-patients-with-portal-hypertension-related-bleeding-and-an-indication-for-early-tips-a-large-multicentre-audit-with-real-life-results
#14
Dominique Thabut, Arnaud Pauwels, Nicolas Carbonell, Andre Jean Remy, Pierre Nahon, Xavier Causse, Jean-Paul Cervoni, Jean-François Cadranel, Isabelle Archambeaud, Slim Bramli, Florent Ehrhard, Philippe Ah-Soune, Florian Rostain, Alexandre Pariente, Julien Vergniol, Jean-Pierre Dupuychaffray, Anne-Laure Pelletier, Florence Skinazi, Anne Guillygomarc'h, René-Louis Vitte, Jean Henrion, Stéphanie Combet, Marika Rudler, Christophe Bureau
BACKGROUND: The Baveno VI consensus meeting concluded that an early TIPS must be considered in high-risk cirrhotic patients presenting with variceal bleeding (VB) (Child B + active bleeding at endoscopy or Child C10-13 patients). Whether this therapeutic approach is feasible in a real-life setting remains unclear. AIMS: To determine (1) the proportion of patients eligible for early-TIPS among cirrhotic patients with VB, (2) the proportion of these patients who underwent early-TIPS placement and the main reasons for discarding TIPS, and (3) the outcomes of patients who experienced early-TIPS placement in a large, national, prospective, multicentre audit including academic and non-academic centres...
September 13, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28915680/combination-therapy-versus-pharmacotherapy-endoscopic-variceal-ligation-or-the-transjugular-intrahepatic-portosystemic-shunt-alone-in-the-secondary-prevention-of-esophageal-variceal-bleeding-a-meta-analysis-of-randomized-controlled-trials
#15
Lu-Lu Lin, Shi-Ming Du, Yan Fu, Hui-Yun Gu, Lei Wang, Zhi-Yuan Jian, Xian-Feng Shen, Jie Luo, Chao Zhang
Patients with liver cirrhosis and variceal hemorrhage are at increased risk of rebleeding. We performed a meta-analysis toassess the clinical efficacy of combination therapy (pharmacotherapy and endoscopic variceal ligation (EVL)) compared with pharmacotherapy, EVL, or transjugular intrahepatic portosystemic shunt (TIPS) alone in the prevention of rebleeding and mortality. A literature search of MEDLINE, EMBASE, and the Cochrane Controlled Trials Register, up until November 2016, identified relevant randomized controlled trials...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28883536/techniques-and-long-term-effects-of-transjugular-intrahepatic-portosystemic-shunt-on-liver-cirrhosis-related-thrombotic-total-occlusion-of-main-portal-vein
#16
Lei Wang, Fuliang He, Zhendong Yue, Hongwei Zhao, Zhenhua Fan, Mengfei Zhao, Bin Qiu, Jiannan Yao, Qiushi Lin, Xiaoqun Dong, Fuquan Liu
Portal vein hypertension (PVH) in liver cirrhosis complicated with portal venous thrombosis (PVT) has been mainly treated with transjugular intrahepatic portosystemic shunt (TIPS). The clinical effects of TIPS have been confirmed, however, no large-scale studies have been focused on technical analyses and a long-term follow-up, especially on thrombotic total occlusion of main portal vein (MPV). To demonstrate critical techniques and clinical outcome of TIPS on liver cirrhosis-related thrombotic total occlusion of MPV, 98 patients diagnosed with liver cirrhosis related thrombotic total occlusion of MPV and treated with TIPS from January 2000 to January 2010 were retrospectively analyzed...
September 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28763854/-transjugular-intrahepatic-portosystemic-shunt-for-esophagogastric-variceal-bleeding-in-liver-cirrhosis-intended-population-and-timing
#17
Y Lyu, G H Han, D M Fan
Esophagogastric variceal bleeding is a life-threatening complication of cirrhotic portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective method for the treatment and prevention of esophagogastric variceal bleeding; however, right timing of TIPS and selection of appropriate candidates for TIPS are of vital importance in improving patients' survival rate and reducing mortality rate. This article reviews the intended population and right timing of TIPS for the treatment and prevention of esophagogastric variceal bleeding in liver cirrhosis...
June 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28753738/the-modification-of-splenic-stiffness-on-acoustic-radiation-force-impulse-parallels-the-variation-of-portal-pressure-induced-by-transjugular-intrahepatic-portosystemic-shunt
#18
Adriano De Santis, Silvia Nardelli, Chiara Bassanelli, Marinella Lupo, Claudia Iegri, Carmela Anna Di Ciesco, Mariana Forlino, Alessio Farcomeni, Oliviero Riggio
BACKGROUND: Spleen and liver stiffness measured by Acoustic radiation force impulse (ARFI) imaging has been showed to be useful in identifying patients with portal hypertension. AIM: to establish if the modification of portal pressure induced by a TIPS parallels the modification of spleen or liver stiffness measured by ARFI in order to understand if ARFI may be used to monitor the modification of portal pressure in patients with cirrhosis. PATIENTS AND METHODS: 38 patients with severe portal hypertension underwent liver stiffness (LS) and spleen stiffness (SS) before TIPS and one week after TIPS...
July 28, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28729141/effects-of-transjugular-intrahepatic-portosystemic-shunt-tips-on-blood-volume-distribution-in-patients-with-cirrhosis
#19
Troels M Busk, Flemming Bendtsen, Jens H Henriksen, Stefan Fuglsang, Jens O Clemmesen, Fin S Larsen, Søren Møller
BACKGROUND: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. AIMS: To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. METHODS: Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS...
June 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28661458/adipokines-in-liver-cirrhosis
#20
REVIEW
Christa Buechler, Elisabeth M Haberl, Lisa Rein-Fischboeck, Charalampos Aslanidis
Liver fibrosis can progress to cirrhosis, which is considered a serious disease. The Child-Pugh score and the model of end-stage liver disease score have been established to assess residual liver function in patients with liver cirrhosis. The development of portal hypertension contributes to ascites, variceal bleeding and further complications in these patients. A transjugular intrahepatic portosystemic shunt (TIPS) is used to lower portal pressure, which represents a major improvement in the treatment of patients...
June 29, 2017: International Journal of Molecular Sciences
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