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Postshunt encephalopathy in liver transplanted children with portal vein thrombosis

P Tissières1, D Pariente, C Chardot

  • 1Groupe de Transplantation Hépatique Pédiatrique, Assistance Publique, H pitaux de Paris, France.

Transplantation
|December 16, 2000
PubMed

Insights

Portosystemic shunting can cause acute encephalopathy in liver transplant recipients with portal vein thrombosis. This complication can be fatal, necessitating alternative treatments to restore liver graft blood flow.

Area of Science:

  • Hepatology
  • Transplantation Surgery
  • Pediatric Gastroenterology

Background:

  • Portal hypertension in liver transplant recipients with portal vein thrombosis (PVT) is often managed with surgical portosystemic shunting.
  • PVT is a significant complication following liver transplantation, impacting graft function and patient outcomes.

Observation:

  • Two pediatric liver transplant recipients with PVT developed acute encephalopathy after portosystemic shunt creation or preservation.
  • One patient underwent a mesocaval H-type shunt, while the other had a spontaneous splenorenal shunt preserved.

Findings:

  • Post-shunt encephalopathy occurred months to years after transplantation in both cases.
  • One child succumbed to the complications of encephalopathy, highlighting a dismal outcome.

Implications:

  • Portosystemic shunting carries a risk of severe neurological complications, including fatal encephalopathy, in pediatric liver transplant recipients with PVT.
  • Alternative strategies that restore hepatopetal blood flow to the liver graft are crucial for managing PVT in this vulnerable population.
Abstract

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