Hemodynamic and metabolic effects of transjugular intrahepatic portosystemic shunt (TIPS) during anesthesia for orthotopic liver transplantation

Mario Antonini, Giorgio Della Rocca, Francesco Pugliese, Livia Pompei, Micaela Maritti, Cecilia Coccia, Alessandro Gasparetto, Raffaello Cortesini

Research output: Contribution to journalArticle

Abstract

Recently, the transjugular intrahepatic portosystemic shunt (TIPS) has been advocated as a safe bridge to orthotopic liver transplantation (OLT). We retrospectively studied 53 consecutive cirrhotic patients who underwent OLT: 27 patients with TIPS were compared to 26 controls. Hemodynamic and oxyphoretic data (Fick method) were collected during six phases of OLT. There were no significant differences in demographic data and Child-Pugh class, nor in surgical time and blood product requirements before the anhepatic phase between TIPS patients and controls. In the TIPS group, we observed a marked hyperdynamic profile with a lower systemic vascular resistance index, higher cardiac index, and depressed oxygen consumption before native liver removal. During the same period, the TIPS group developed a greater acidosis and was treated with a larger amount of Na-HCO3. Following the anhepatic phase, no differences between the two groups were detected. All transplantations were successful, and no complications related to TIPS were observed. These results seem to be the consequence of a reduced liver function reserve with a direct hemodynamic effect due to the TIPS.

Original languageEnglish
Pages (from-to)403-407
Number of pages5
JournalTransplant International
Volume9
Issue number4
DOIs
Publication statusPublished - 1996

Keywords

  • Liver transplantation, TIPS
  • Portosystemic shunt, liver transplantation
  • TIPS, liver transplantation

ASJC Scopus subject areas

  • Transplantation

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