OBJECTIVE: To determine the safety and efficacy of transjugular intrahepatic portosystemic shunts (TIPS) in controlling @entity548 from esophageal varices in @entity1 awaiting liver transplantation. DESIGN: Prospective, uncontrolled trial. SETTING: University medical center with an active liver transplant program. @entity1 : Thirteen @entity1 referred for liver transplantation with either active @entity548 or recurrent @entity548 despite sclerotherapy; four @entity1 had been previously treated with surgical portosystemic shunts. INTERVENTION: An intrahepatic portosystemic shunt created via a transjugular approach to the hepatic veins using expandable, flexible metallic stents. MEASUREMENTS: Portal pressures before and after the creation of the shunt, the direction of portal blood flow at differing diameters of the shunts, procedure-related complications, and outcome in terms of survival, liver transplantation, and recurrent @entity548 . MAIN RESULTS: The transjugular intrahepatic portosystemic shunt was placed successfully in 13 @entity1 , and @entity548 was controlled acutely in all 13. After the procedure, the mean portal pressure decreased from 34 +/- 8.9 cm @entity2507 to 22.4 +/- 5.4 cm @entity2507 (P less than 0.001). No complications were associated with the procedure; however, two @entity1 died of causes unrelated to the procedure. Seven @entity1 subsequently underwent liver transplantation and are doing well, and three @entity1 are being managed conservatively. Bleeding recurred in one @entity1 102 days after the procedure secondary to @entity432 caused by neointimal proliferation. CONCLUSION: Placement of a transjugular intrahepatic portosystemic shunt is apparently safe and effective therapy for @entity548 in @entity1 referred for liver transplantation.

Using transjugular intrahepatic portosystemic shunts to control XXXX before liver transplantation.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity2507 :: ('CHEBI:33813', 'Chemical') :: ['H2O'] @entity432 :: ('MESH:D001157', 'Disease') :: ['shunt occlusion'] @entity548 :: ('MESH:D006470', 'Disease') :: ['variceal hemorrhage', 'variceal bleeding', 'bleeding']
@entity548 :: (MESH:D006470,Disease) :: ['variceal bleeding']
