Schemmer P, Radeleff B, Flechtenmacher C, Mehrabi A, Richter GM, Büchler MW, Schmidt J. TIPSS for variceal hemorrhage after living related liver transplantation: A dangerous indication. World J Gastroenterol 2006; 12(3): 493-495 [PMID: 16489658 DOI: 10.3748/wjg.v12.i3.493]
Corresponding Author of This Article
Dr Peter Schemmer, Department of General Surgery, Ruprecht-Karls-University, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. peterschemmer@med.uni-heidelberg.de
Article-Type of This Article
Case Report
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World J Gastroenterol. Jan 21, 2006; 12(3): 493-495 Published online Jan 21, 2006. doi: 10.3748/wjg.v12.i3.493
TIPSS for variceal hemorrhage after living related liver transplantation: A dangerous indication
Peter Schemmer, Boris Radeleff, Christa Flechtenmacher, Arianeb Mehrabi, Götz M Richter, Markus W Büchler, Jan Schmidt
Peter Schemmer, Arianeb Mehrabi, Markus W Büchler, Jan Schmidt, Department of General Surgery, Ruprecht-Karls-University, 69120 Heidelberg, Germany
Boris Radeleff, Götz M Richter, Department of Radiology, Ruprecht-Karls-University, 69120 Heidelberg, Germany
Christa Flechtenmacher, Department of Pathology, Ruprecht-Karls-University, 69120 Heidelberg, Germany
Correspondence to: Dr Peter Schemmer, Department of General Surgery, Ruprecht-Karls-University, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. peterschemmer@med.uni-heidelberg.de
Telephone: +49-6221/56-6110 Fax: +49-6221/56-4215
Received: July 15, 2005 Revised: July 28, 2005 Accepted: August 3, 2005 Published online: January 21, 2006
Abstract
The introduction of transjugular intrahepatic portal-systemic stent-shunt (TIPSS) has been a major breakthrough in the treatment of portal hypertension, which has evolved to a large extent, into a routine procedure. A 21-year-old male patient with progressive graft fibrosis/cirrhosis requiring TIPSS for variceal hemorrhage in the esophagus due to portal hypertension was unresponsive to conventional measures two years after living related liver transplantation (LDLT). Subsequently, variceal hemorrhage was controlled, however, liver function decreased dramatically with consecutive multi organ failure. CT scan revealed substantial necrosis in the liver. The patient underwent successful “high urgent” cadaveric liver transplantation and was discharged on postoperative d 20 in a stable condition.
