26th Congress of the Spanish Liver Transplantation SocietyCandidates for liver transplantationUse of Peritoneovenous Shunt for the Management of Refractory Ascites
Section snippets
Indications for PVS
At our center, PVSs (DS or SPS) are offered to patients with RA due to chronic liver failure, who have become refractory to diuretics treatment and with contraindications to transjugular intrahepatic portosystemic shunting (TIPS) due to encephalopathy. Patient candidates may or may not be on a transplant waiting list. Renal function, anesthetic risk, and cardiac output are fully screened in all patients. The diagnosis of heart insufficiency is a contraindication for PVS as this procedure may
Results
From 2013, 7 PVS procedures were performed at our center on 5 patients. Six were DS procedures and 1 was an SPS procedure. The main cause of end-stage liver disease was alcohol abuse. In 2 cases, PVS was indicated to improve renal function and QOL before the liver transplant and in 3 cases to control the RA in patients with no indication for transplantation. The mean age was 61 (range, 54–68) years. In 1 case, surgery was accompanied by inguinal hernia repair due to a giant hernia that led to
Discussion
Current guidelines [7] consider intensive diuretics treatment with additional dietary sodium restriction and large-volume paracentesis as the primary treatment options for patients with refractory ascites. However, the negative impact on systemic hemodynamics and renal function are the main adverse events associated with these strategies. TIPS is a viable treatment option in chronic disease patients, but may be associated with higher rates of hepatic encephalopathy. Both LVP and TIPS may lead
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Current treatment options of refractory ascites in liver cirrhosis – A systematic review and meta-analysis
2022, Digestive and Liver DiseaseCitation Excerpt :Baseline characteristics are found in Supp. Table 7. The studies differed in terms of which shunt system they used: LeVeen shunts [74–77], saphenoperitoneal shunts [82–84], Denver shunts [78–81], unclear [73,85] or more than one option [72]. MELD score was only reported in one study [81] and Child-Pugh scores in three studies [74,76,82].
Peritoneal and Pleural Drains in Pediatric Hematopoietic Cell Transplant Recipients with Veno-Occlusive Disease are Safe and Do Not Adversely Impact Clinical Outcomes
2023, Hematology/ Oncology and Stem Cell TherapyInterventional Management of Portal Hypertension in Cancer Patients
2022, Current Oncology ReportsTunneled peritoneal catheter for refractory ascites in cirrhosis: A randomized case-series
2020, Medicina (Lithuania)Surgery and IVR for the treatment of portal hypertension
2019, Journal of Japanese Society of Gastroenterology
M.D.A., R.C., and I.G.-L. have contributed equally to this study.