Transjugular intrahepatic portosystemic shunt for the treatment of sinusoidal obstruction syndrome in a liver transplant recipient and review of the literature

Authors

  • Isabel Campos-Varela,

    Corresponding author
    1. Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
    2. Centro de Investigación Biomedica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
    3. Universitat Autónoma de Barcelona, Departament de Medicina
    • Department of Internal Medicine (Liver Unit), Vall d'Hebron University Hospital, Passeig Vall d'Hebron 119-129, Barcelona, Spain 08035
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    • Telephone: 34.93.274.61.40; FAX: 34.93.274.60.68

  • Lluís Castells,

    1. Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
    2. Centro de Investigación Biomedica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
    3. Universitat Autónoma de Barcelona, Departament de Medicina
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  • Cristina Dopazo,

    1. Liver Transplant Unit, Department of HPB-Surgery and Transplant, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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  • Mercedes Pérez-Lafuente,

    1. Radiology Department, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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  • Helena Allende,

    1. Pathology Department, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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  • Oscar Len,

    1. Infectious Diseases Department, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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  • Lluís Llopart,

    1. Critical Care Department, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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  • Victor Vargas,

    1. Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
    2. Centro de Investigación Biomedica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)
    3. Universitat Autónoma de Barcelona, Departament de Medicina
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  • Ramón Charco

    1. Liver Transplant Unit, Department of HPB-Surgery and Transplant, Hospital Universitari Vall d' Hebron, Institut de Recerca (VHIR), Barcelona, Spain
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Abstract

Sinusoidal obstruction syndrome (SOS) is a rare, life-threatening clinical syndrome resulting from sinusoidal congestion, and it is characterized by hepatomegaly, ascites, weight gain, and jaundice. The frequency of this condition after liver transplantation (LT) is low, but when SOS is severe and refractory to medical therapy, the ultimate solution is retransplantation. We describe a patient with SOS after LT who was successfully treated by the placement of a transjugular intrahepatic portosystemic shunt (TIPS). Although information on this approach is scarce because of the low incidence of SOS in LT patients, we review the available literature on treating this condition with a TIPS. On the basis of the reported information and our patient's outcome, we suggest that prompt TIPS placement can be considered for SOS when medical treatment fails. Nonetheless, a formal assessment and prospective studies are needed to confidently indicate TIPS placement in this situation. Liver Transpl 18:201–205, 2012. © 2011 AASLD.

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