[Liver transplantation after surgical shunt or transjugular intrahepatic portasystemic shunt]

Abstract

The goal of this study was to assess the influence of prior treatment of bleeding esophageal varices on liver transplantation. After sclerotherapy the results of liver transplantation were identical to those achieved in patients without previous variceal hemorrhage (74% 1-year survival). The results of liver transplantation to patients who already had surgical shunts were dismal. Four of nine patients with portocaval or Warren shunts were long-term survivors. In comparison, the intraoperative course in five patients with transjugular intrahepatic portosystemic stent shunts (TIPSS) was uneventful and four of these were long-term survivors. This has led us to adopt TIPSS as the treatment modality of choice for patients with bleeding varices awaiting liver transplantation.