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Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
07:10

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy

Published on: June 18, 2020

Feasibility and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in children

Angelo Di Giorgio1, Roberto Agazzi, Daniele Alberti

  • 1Paediatric Hepatology, Gastroenterology and Transplantation, Ospedali Riuniti di Bergamo, Bergamo, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|January 10, 2012
PubMed

Insights

Transjugular intrahepatic portosystemic shunt (TIPS) is a feasible and effective treatment for severe pediatric portal hypertension complications like bleeding and ascites. This procedure offers a valuable option for managing these conditions in children, serving as a bridge to transplantation or for long-term care.

Area of Science:

  • Interventional Radiology
  • Pediatric Gastroenterology
  • Hepatology

Background:

  • Portal hypertension (PH) complications are serious in children.
  • Transjugular intrahepatic portosystemic shunt (TIPS) is used in adults but considered temporary and challenging in children.

Purpose of the Study:

  • To report the first pediatric series of Transjugular intrahepatic portosystemic shunt (TIPS) procedures.
  • To review the feasibility and efficacy of TIPS in managing pediatric portal hypertension.

Main Methods:

  • TIPS was performed using expanded polytetrafluoroethylene-covered Viatorr stent grafts in children with severe PH unresponsive to standard treatments.
  • Indications included cirrhotic PH, noncirrhotic PH, and portal vein thrombosis in native and transplanted livers.

Main Results:

  • TIPS was successfully placed in 11 of 13 children (median age 9.8 years).
  • Portosystemic gradient significantly decreased (P < 0.00001), and PH complications resolved in 91% of patients.
  • Shunts remained patent, with some patients proceeding to liver transplantation.

Conclusions:

  • Transjugular intrahepatic portosystemic shunt (TIPS) is feasible and effective for pediatric ascites or gastrointestinal bleeding unresponsive to other treatments.
  • TIPS should be considered for managing PH complications in children with native or transplanted livers, acting as a bridge to transplantation or for long-term management.
Abstract

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