Ann Liver Transplant.  2023 May;3(1):17-22. 10.52604/alt.23.0009.

Rescue therapy using transjugular intrahepatic portosystemic shunt for sudden-onset portal vein thrombosis-associated ascites after living donor liver transplantation

• Yang G
• Hwang S
• Ko GY
• Song GW
• Moon DB
• Jung DH
• Ahn CS
• Ha TY
• Park GC

• KMID: 2560917
• DOI: http://doi.org/10.52604/alt.23.0009

Abstract

Sudden-onset portal vein (PV) thrombosis can result in refractory massive ascites. Transjugular intrahepatic portosystemic shunt (TIPS) can be a bridge or rescue therapy for the restoration of portal blood flow and control of ascites. We present one case of a liver transplant recipient who underwent TIPS as a rescue therapy to control PV thrombosis-associated refractory ascites. The patient who had received living donor liver transplantation 15 years before had PV thrombosis, which resulted in sudden-onset massive ascites. TIPS was performed to control refractory ascites. Soon after TIPS, the amount of ascites decreased rapidly, and the patient was discharged at 3 weeks after TIPS. Anticoagulation was maintained to prevent thrombus formation. Liver function was maintained well after TIPS, but the patient suffered from several episodes of hepatic encephalopathy. At 6 months after TIPS, stent flow was well maintained with stable liver function. Retransplantation was planned for the patient. In conclusion, the present case suggests that TIPS can be used as a rescue therapy for refractory ascites in liver transplant recipients with graft failure-associated portal vein thrombosis.

Keyword

Portal vein thrombosis; Portal hypertension; Refractory ascites; Graft failure; Radiologic intervention