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Updated: Mar 6, 2026
Technique of Porcine Liver Procurement and Orthotopic Transplantation using an Active Porto-Caval Shunt
Published on: May 7, 2015
Portosystemic shunt as a bridge to liver transplantation in infants: A comparison of two techniques
Dor Yoeli1,2, N Thao N Galván1,2, Daniel J Ashton3,4
1Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Hepatobiliary Surgery, Baylor College of Medicine, Houston, TX, USA.
Insights
Transjugular intrahepatic portosystemic shunt (TIPS) procedures can bridge infants to liver transplantation. A novel DIPS technique offers a valuable alternative for infants with challenging anatomy, successfully preventing variceal bleeding.
Area of Science:
- Interventional Radiology
- Pediatric Gastroenterology
- Hepatology
Background:
- End-stage liver disease necessitates liver transplantation.
- Portosystemic shunts are crucial for managing variceal bleeding in these patients.
- Conventional transjugular intrahepatic portosystemic shunt (TIPS) is challenging in infants due to small vasculature.
Abstract:
Portosystemic shunts can serve as a bridge to liver transplantation in patients with end-stage liver disease by providing portal decompression to treat life-threatening variceal bleeding and prevent recurrent episodes until an organ becomes available. The conventional TIPS procedure, however, is technically challenging to perform in infants due to the small size of their intrahepatic vasculature. We report two cases of emergent creation of portosystemic shunts as a bridge to liver transplantation in infants with life-threatening variceal bleeding using a conventional TIPS technique in the first case and a percutaneous DIPS technique in the other. Both procedures were successful at reducing the portosystemic pressure gradient and preventing further variceal bleeds until a liver transplant could be performed. The novel percutaneous DIPS procedure is a valuable alternative to the conventional TIPS in infants, as it is better suited for small or challenging intrahepatic vascular anatomy.
