Lack of efficacy of TIPS for hepatopulmonary syndrome

Hepatopulmonary syndrome

“…In this patient, the cardiac output significantly increased and the lung perfusion scan remained positive after TIPS placement, suggesting that intrapulmonary vasodilation persisted and that redistribution of pulmonary blood flow to normal vascular regions in the lung may have accounted for improved oxygenation. In another report it was observed that TIPS did not improve oxygenation in a patient with HPS, and two patients in whom HPS was detected after placement of a functioning TIPS were described [42]. We also observed no improvement in oxygenation after TIPS in one patient with severe HPS (PO 2 32 mm Hg) and observed the development of HPS (PO 2 55 mm Hg) in a patient with a patent TIPS (Unpublished observations).…”

Pulmonary–Hepatic vascular Disorders (PHD)

“…To date, only a few case reports using transjugular intrahepatic portosystemic shunt (TIPS) for HPS have been published, and have shown variable short-term effects on pulmonary gas exchange [134,137]. Therefore, insufficient data are available to support TIPS as a compassionate therapeutic approach in HPS [138].…”

Dyspnoea, Cyanosis and Digital Clubbing in a 28-Year-Old Patient as a Result of Hepatopulmonary Syndrome

“…The results obtained are contradictory, as of today there are no clear-cut criteria that would allow to isolate a group of patients with HPS obtaining measurable benefits by the application of the vascular anastomosis. [14][15][16] As a palliative procedure, embolisaton of thickened vessels or local resections of the pulmonary tissue that contains them is adopted [7]. In connection with the values obtained in gasometry in the patient described herein, the patient was directly qualified to lung transplantation as the target treatment.…”