Portosystemic shunt as a bridge to liver transplantation in infants: A comparison of two techniques

Dor Yoeli, N. Thao N. Galván, Daniel J. Ashton, Kayla R. Kumm, Michael Kueht, Ellen D. Witte, Tamir A. Miloh, Ronald T. Cotton, Abbas Rana, Christine A. O'Mahony, John A. Goss

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Portosystemic shunts can serve as a bridge to liver transplantation in patients with end-stage liver disease by providing portal decompression to treat life-threatening variceal bleeding and prevent recurrent episodes until an organ becomes available. The conventional TIPS procedure, however, is technically challenging to perform in infants due to the small size of their intrahepatic vasculature. We report two cases of emergent creation of portosystemic shunts as a bridge to liver transplantation in infants with life-threatening variceal bleeding using a conventional TIPS technique in the first case and a percutaneous DIPS technique in the other. Both procedures were successful at reducing the portosystemic pressure gradient and preventing further variceal bleeds until a liver transplant could be performed. The novel percutaneous DIPS procedure is a valuable alternative to the conventional TIPS in infants, as it is better suited for small or challenging intrahepatic vascular anatomy.

Original languageEnglish (US)
Article numbere12915
JournalPediatric Transplantation
Volume21
Issue number4
DOIs
StatePublished - Jun 1 2017
Externally publishedYes

Keywords

  • end-stage liver disease
  • esophageal and gastric varices
  • gastrointestinal hemorrhage
  • liver transplantation
  • transjugular intrahepatic portosystemic shunt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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    Yoeli, D., Galván, N. T. N., Ashton, D. J., Kumm, K. R., Kueht, M., Witte, E. D., Miloh, T. A., Cotton, R. T., Rana, A., O'Mahony, C. A., & Goss, J. A. (2017). Portosystemic shunt as a bridge to liver transplantation in infants: A comparison of two techniques. Pediatric Transplantation, 21(4), [e12915]. https://doi.org/10.1111/petr.12915