Disease relevance of Portasystemic Shunt, Transjugular Intrahepatic

• Ascites improved after TIPSS in 36 patients (87.8%), but reaccumulated in seven (17.5%), associated with shunt dysfunction in five (SBP 2, IH 3, HVS 2) [1].

High impact information on Portasystemic Shunt, Transjugular Intrahepatic

• In patients with preserved liver function occlusion of the shunt may be prevented by phenprocoumon treatment in the first 3 months after TIPSS placement [2].
• Patients with lower serum bilirubin and serum creatinine prior to TIPSS insertion had greater response at 1 and 4 weeks, respectively [3].
• The theta/alpha ratio decreased after TIPSS, despite an elevated arterial ammonia level [4].
• BACKGROUND: It has been reported that preoperative transjugular intrahepatic portosystemic stent-shunt (TIPSS) reduces peri-operative transfusion requirements during orthotopic liver transplant, and may result in fewer episodes of poor, early graft function by reducing portosystemic shunting, thus improving portal blood supply to the graft [5].
• Main predictors (P< 0.01) in this group (group-1: Child-Pugh score 10A, 10B, 10C) were graded (1, 2 or 3 points representing low, medium and high risk, respectively) and summarized as a Bonn TIPSS early mortality (BOTEM) score [6].

Anatomical context of Portasystemic Shunt, Transjugular Intrahepatic

• Full blood count, reticulocyte count, serum haptoglobin, urinary haemosiderin, examination of the peripheral blood smear and spleen size (ultrasonography) were measured prior to and 3, 7 and 30 days after TIPSS and 6-monthly thereafter [7].

Associations of Portasystemic Shunt, Transjugular Intrahepatic with chemical compounds

• Urinary sodium and creatinine clearance improved significantly following TIPSS (P < 0.001, P < 0.001, respectively) [8].
• In those who respond to octreotide and midodrine, the subsequent placement of a transjugular intrahepatic portasystemic shunt (TIPS) has been shown to produce a sustained improvement in renal function [9].
• Sclerotherapy, tamponade, vasoconstrictor therapy and oesophageal transection were available to 87.5-97.5% clinicians, compared with trans-jugular intrahepatic porto-systemic shunts (TIPSS) (39.5%) and band ligation (27%) [10].
• To arrest bleeding, sclerotherapy, tamponade, octreotide/somatostatin and vasopressin/glypressin were used by 75.5%, 44.5%, 37% and 32% respectively (many used > 1 treatment) and if bleeding continued, transection, TIPSS and shunt surgery were considered by 44.5%, 27% and 6% [10].

Gene context of Portasystemic Shunt, Transjugular Intrahepatic

• ANP was not significantly different from normal controls and did not change significantly following TIPSS [8].

Analytical, diagnostic and therapeutic context of Portasystemic Shunt, Transjugular Intrahepatic

• Compared to the conventional EEG the theta/alpha ratio reflected better metabolically conditioned electroencephalographic changes after TIPSS [4].

References