Transjugular Intrahepatic Porto-Caval Shunt (TIPS) in treatment of portal hypertension in liver transplant recipiens

TIPS, as non-operative treatment of portal hypertension allows for safe awaiting liver transplantation for patients otherwise at high risk of hemorrhage from oesophageal varices veins. When endoscopic treatment fails, TIPS is a plausible and less hazardous alternative for surgical porto-systemic shunts. It is of particular importance in patients with liver failure and unacceptable operative risk (group C in Child-Pugh classification). TIPS was done in 96 patients aged 16-68 years (average 52 years). According to Child-Pugh classification, which documents a stage of liver failure, 60 patients (62%) were in group B, and 36 (38%) in group C. Patients from group C are in most severe condition and at highest operative risk. Postalcoholic and postinflammatory liver cirrhosis is a main cause of portal hypertension. TIPS was done in 26 patients expecting liver transplantation. Twenty patients had subsequently undergone liver transplatation while remaining 6 are still on the waiting list. In 15 patients stenosis of the shunt was observed within a year. Stenosis was then treated with intervention rediology and implantation of suplemental stents. TIPS as a non-operative option for treatment of portal hypertension gives a patient an opportunity to await liver transplantation with maximum possible safety. Considering these facts, TIPS is called a bridge to liver transplantation.