Transjugular intrahepatic portosystemic shunt creation using a transjugular and ultrasound-guided percutaneous approach in a liver transplant recipient.

摘要

At a medical center with an active liver transplantation service, various situations arise that benefit from the expertise of the interventional radiologist. The interventional radiologist may be called upon to create a transjugular intrahepatic portosystemic shunt (TIPS) to reduce portal hypertension before transplantation, especially in patients with cirrhosis. Occasionally, these patients may develop or redevelop portal hypertension after receiving a liver transplant and may require a portosystemic shunt in the transplanted liver. These patients can present with unique challenges as a result of the altered anatomy of the inferior vena cava (IVC) depending on the way the native IVC and donor IVC are anastomosed. The donor portion of the IVC can be anastomosed inline with the patient's native IVC, resembling normal anatomy, or a common variant is to anastomose the donor IVC adjacent to or side-by-side with the patient's native IVC in a "piggyback" fashion.