Results - TIPS is effective for controlling and preventing bleeding due to portal hypertension. However, as mentioned above, the stent does not remain patent indefinitely due to thrombosis occlusions and therefore TIPS should not be considered definitive therapy. Complications include perforation of the liver capsule. There is an increased risk of hepatic encephalopathy with nonselective shunts since blood flow is diverted away from the liver. Selective shunts are contraindicated in patients with ascites and may worsen ascites since it does not decompress the hepatic lymphatics.
Some controversies exist regarding liver transplantation for alcoholic liver disease.
The ethical issue of the limited resource of liver donors is also present. While there are no clear answers to these issues, liver transplantation for alcoholic liver disease is associated with very good outcomes. Cardiac evaluation Technical considerations - an arteriogram is performed to assess patency of the portal vein, hepatic artery, etc. The student is referred to other sources for a more indepth discussion of immunosuppressive anti-rejection therapy. Complications Complications of liver transplantation include hepatic artery thrombosis, primary nonfunction of the transplanted liver, portal vein thrombosis, and bile leak.