Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Role of Transjugular Intrahepatic Portosystemic Shunt in the Liver Transplant Setting

Simone Di Cola
ORCID logo ,
Lucia Lapenna
ORCID logo ,
Jakub Gazda
,
Stefano Fonte
,
Giulia Cusi
,
Samuele Esposito
,
Marco Mattana
,
Manuela Merli
* ORCID logo
Version 1 : Received: 12 October 2023 / Approved: 13 October 2023 / Online: 13 October 2023 (08:00:51 CEST)

A peer-reviewed article of this Preprint also exists.

Di Cola, S.; Lapenna, L.; Gazda, J.; Fonte, S.; Cusi, G.; Esposito, S.; Mattana, M.; Merli, M. Role of Transjugular Intrahepatic Portosystemic Shunt in the Liver Transplant Setting. J. Clin. Med. 2024, 13, 600. Di Cola, S.; Lapenna, L.; Gazda, J.; Fonte, S.; Cusi, G.; Esposito, S.; Mattana, M.; Merli, M. Role of Transjugular Intrahepatic Portosystemic Shunt in the Liver Transplant Setting. J. Clin. Med. 2024, 13, 600.

Abstract

Liver transplantation is currently the only curative therapy for patients with liver cirrhosis. Not all patients in the natural course of the disease will undergo transplantation, but the majority of them will experience portal hypertension and its complications. In addition to medical and endoscopic therapy, a key role in managing these complications is played by the placement of a transjugular intrahepatic portosystemic shunt (TIPS). Some indications for TIPS placement are well-established and they are expanding and broadening over time. This review aims to describe the role of TIPS in managing patients with liver cirrhosis, considering them as potential candidates for liver transplantation. As far as is known TIPS placement seems not to affect the surgical aspects of liver transplantation, in terms of intra operative bleeding rates, postoperative complications or length of stay in the Intensive Care Unit. However, the placement of a TIPS “towards transplant" can offer advantages in terms of enhancing the patient's clinical condition at the time of transplantation and improving patient survival. Additionally, the TIPS procedure can help preserve the technical feasibility of the transplant itself. In this context, indications for TIPS placement may be expanded and considered at an earlier stage. TIPS insertion can also lead to serious adverse events and there are no evidence-based recommendations on this topic to date. For these reasons further studies are needed to make reliable recommendations for TIPS in the pre-transplant setting.

Keywords

Transjugular Intrahepatic Portosystemic Shunt; TIPS; liver transplantation; bridge to transplant; timing

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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