Utility of transjugular intrahepatic

Background: Transjugular intrahepatic portosys-temic shunts (TIPS) have been used to control symp-tomatic portal hypertension in patients awaiting liver transplant. Although their role in pretransplantation patients is well established, their role in posttrans-plantation patients is unclear. Study Design: Retro-spective analyses were performed for 18 liver-trans-plant recipients who underwent TIPS for recurrent end-stage liver disease. Patients were evaluated in re-gard to gender, age, diagnoses, allograft type, indica-tion for TIPS, portal pressures, laboratory results, Model for End-Stage Liver Disease (MELD) score, and outcomes. Results: Median days from transplant to TIPS was 939 days (range, 122 to 3,415 days). Indica-tions included variceal bleeding (n 2) and ascites (n 16). Ten patients (56%) responded to TIPS; TIPS prevented bleeding in both patients with varices, and it achieved symptomatic benefit in half of all patients with ascites. TIPS reduced median portal pressure