Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned

TIPSS is safe and effective procedure for relieving portal hypertension by creating a low resistance portosystemic shunt. TIPSS reduces portal perfusion by 80 to 100% which then gradually gets partially compensated by increased flow from hepatic artery. Post TIPSS liver function shows brief deterior...

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Autores principales:	Ritu Verma, Nishchint Jain, Abhishek Arora, Shivanand Gamangatti, Shailendra Chaturvedi
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	acute liver failure hepatic encephalopathy ptlf tipss Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/aa487bbb837b4e67989026f852dddb8f
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spelling	oai:doaj.org-article:aa487bbb837b4e67989026f852dddb8f2021-11-13T23:32:30ZBeyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned0971-30261998-380810.1055/s-0041-1736403https://doaj.org/article/aa487bbb837b4e67989026f852dddb8f2021-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1736403https://doaj.org/toc/0971-3026https://doaj.org/toc/1998-3808TIPSS is safe and effective procedure for relieving portal hypertension by creating a low resistance portosystemic shunt. TIPSS reduces portal perfusion by 80 to 100% which then gradually gets partially compensated by increased flow from hepatic artery. Post TIPSS liver function shows brief deterioration which tends to start recovering in few weeks. However, progressive liver failure requiring emergency transplant or death remains a serious concern after TIPSS creation. The causes of post TIPSS liver failure are diverse and difficult to predict. Due to its rarity the definition of post TIPSS liver decompensation is also not well described in literature. Till date MELDNa score has been considered as the most reliable predictor of post TIPSS liver decompensation. In common practice post TIPSS liver failure is less likely in patients with model for end-stage liver disease (MELD) score less than 18. We have experienced two unusual cases of post-TIPSS liver failure (PTLF) in patients with initial acceptable/low MELD score and the importance of non-MELD factors that may negatively influence post TIPSS outcome. Most of these can be routinely investigated prior to creating shunt thereby identifying patients at high risk of developing PTLF.Ritu VermaNishchint JainAbhishek AroraShivanand GamangattiShailendra ChaturvediThieme Medical and Scientific Publishers Pvt. Ltd.articleacute liver failurehepatic encephalopathyptlftipssMedical physics. Medical radiology. Nuclear medicineR895-920ENIndian Journal of Radiology and Imaging, Vol 31, Iss 03, Pp 618-622 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute liver failure hepatic encephalopathy ptlf tipss Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	acute liver failure hepatic encephalopathy ptlf tipss Medical physics. Medical radiology. Nuclear medicine R895-920 Ritu Verma Nishchint Jain Abhishek Arora Shivanand Gamangatti Shailendra Chaturvedi Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
description	TIPSS is safe and effective procedure for relieving portal hypertension by creating a low resistance portosystemic shunt. TIPSS reduces portal perfusion by 80 to 100% which then gradually gets partially compensated by increased flow from hepatic artery. Post TIPSS liver function shows brief deterioration which tends to start recovering in few weeks. However, progressive liver failure requiring emergency transplant or death remains a serious concern after TIPSS creation. The causes of post TIPSS liver failure are diverse and difficult to predict. Due to its rarity the definition of post TIPSS liver decompensation is also not well described in literature. Till date MELDNa score has been considered as the most reliable predictor of post TIPSS liver decompensation. In common practice post TIPSS liver failure is less likely in patients with model for end-stage liver disease (MELD) score less than 18. We have experienced two unusual cases of post-TIPSS liver failure (PTLF) in patients with initial acceptable/low MELD score and the importance of non-MELD factors that may negatively influence post TIPSS outcome. Most of these can be routinely investigated prior to creating shunt thereby identifying patients at high risk of developing PTLF.
format	article
author	Ritu Verma Nishchint Jain Abhishek Arora Shivanand Gamangatti Shailendra Chaturvedi
author_facet	Ritu Verma Nishchint Jain Abhishek Arora Shivanand Gamangatti Shailendra Chaturvedi
author_sort	Ritu Verma
title	Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
title_short	Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
title_full	Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
title_fullStr	Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
title_full_unstemmed	Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned
title_sort	beyond meld predictors of post tipss acute liver failure the lesson learned
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/aa487bbb837b4e67989026f852dddb8f
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Beyond MELD Predictors of Post TIPSS Acute Liver Failure the Lesson Learned

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