Percutaneous transjugular intrahepatic stent shunt for treatment of intractable varicose bleeding in paediatric patients

Berger, Herman; Bugnon, F.; Goffette, Pierre; Steiner, W.; Strobelt, M.; Flemmer, Andreas W.; Goyet, Jean de Ville de; Clapuyt, Philippe; Otté, Jean-Bernard; Buts, Jean-Paul

doi:10.1007/bf01954487

Cited by 19 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…10 As an alternative, transjugular intrahepatic portosystemic shunting (TIPS) may be performed as a temporary palliative procedure in patients with variceal bleeding, but experience with this approach is limited in children. 11 Endoscopic injection sclerotherapy has also been reported to be effective in controlling variceal bleeding in children with CF. 12 13 Morbidity and mortality were shown to be lower than with portosystemic shunt surgery, 14 and the incidence of complications was reported to be less than 10%.…”

Section: Methodsmentioning

confidence: 99%

Partial splenectomy in cystic fibrosis patients with hypersplenism

Thalhammer

Eber²,

Uranüs³

et al. 2003

Archives of Disease in Childhood

View full text Add to dashboard Cite

Section: Methodsmentioning

confidence: 99%

Partial splenectomy in cystic fibrosis patients with hypersplenism

Thalhammer

Eber²,

Uranüs³

et al. 2003

Archives of Disease in Childhood

View full text Add to dashboard Cite

“…One could not imagine a poorer candidate for major surgery. It is in the field of preparation before transplantation that the multidisciplinary approach was most helpful, particularly regarding nutrition with new milk formulas developed for cholestatic children (42), parenteral nutrition, control of bleeding esophageal varices [sclerotherapy (43), variceal banding (44), transjugular intrahepatic portosystemic shunt in older children (45)], and correction of salt and water retention. The impressive improvement in the results of liver transplantation, including infants, has induced an earlier referral of patients, allowing the elective transplantation of more children than in the past.…”

Section: Progress In Preoperative Management and Selection Of Candidatesmentioning

confidence: 99%

History of pediatric liver transplantation. Where are we coming from? Where do we stand?

Otté

2002

Pediatric Transplantation

129

View full text Add to dashboard Cite

The history of pediatric liver transplantation cannot be dissociated from one man, Thomas E. Starzl, whose pioneer efforts contributed more than anyone else to what has become a routinely successful clinical procedure. During the pre-cyclosporine era, the pediatric experience was confined nearly exclusively in Denver: first attempt in 1963, first success with survival beyond one year in 1967, cumulative experience with 84 pediatric cases in the pre-cyclosporine era (1967-1979) with a 2-year patient survival rate of 30%. The stampede for the development of other liver transplant centers came with the introduction of cyclosporine in the early eighties. Besides Pittsburgh, seven centers (Brussels, Cambridge and Hanover in Europe; Boston, Dallas, UCLA, Minneapolis in USA) had performed up to 1986 at least 20 pediatric liver transplants each with a long-term (>1 year) patient survival rate ranging between 57% and 83%. At the moment, a long-term patient survival rate in excess of 90% in elective patients -including infants - is commonly obtained in experienced centers. The shortage of size matched liver donors which was responsible for a high death rate on the cadaveric waiting list stimulated the development or technical innovations based on the segmental anatomy of the liver: reduced ('cutdown') liver graft, split graft and living liver transplantation. Challenging technical aspects in the recipient have been solved in order to reduce the incidence of surgical complications like outflow obstruction, arterial and portal thrombosis, and biliary problems. The indications of liver transplantation have been refined; regarding biliary atresia, which is the most frequent indication, a consensus has developed to propose a sequential strategy with a single attempt at hepatoportoenterostomy followed, when it fails, by liver transplantation. Some contra-indications accepted in the past are not currently valid with better understanding of the pathophysiology and/or increased clinical experience; such is the case of the hepatopulmonary syndrome. A major progress in preoperative management has been achieved through a multidisciplinary approach, particularly regarding nutrition and control of portal hypertension-related bleeding and ascites. Perioperatively, liver transplantation has derived benefit from the expertise of anesthetists managing babies with serious conditions and increased experience of the transplant surgeons regarding the knowledge of all the technical modalities, good strategy, technical skills and meticulous control of bleeding. It is well-recognized that children require more immunosuppression than adults. As in adults, the first breakthrough came with the introduction of cyclosporine which more than doubled the one-year patient survival rate. The next advance during the last decade was afforded by FK 506 - Tacrolimus which allows steroid withdrawal with the first year post-transplant in most patients. Besides its efficacy in reducing the incidence of rejection and absence of cosmetic side-effects, the steroid-sp...

show abstract

“…An extensive operation performed in the early postoperative period may lead to a complicated postoperative course and can lead to damage to the donated organ as a result of additional ischemia reperfusion secondary to the required vessel clamping during the revision vascular procedure (3,4). The earliest experience with successful PA stent placement was reported by Berger et al in 1994 (14). In that case, a 63-year-old male lung transplant recipient presented with stenosis of the PA anastomotic site on day 59 after transplant.…”

Section: Discussionmentioning

confidence: 98%

Endovascular Management of Early Lung Transplant–Related Anastomotic Pulmonary Artery Stenosis

Anaya‐Ayala

Loebe

2015

Journal of Vascular and Interventional Radiology

View full text Add to dashboard Cite

Percutaneous transjugular intrahepatic stent shunt for treatment of intractable varicose bleeding in paediatric patients

Abstract: TIPSS may be of benefit in children with severe portal hypertension. It allows control of intractable bleeding, and stabilizes the patients preparing them for subsequent elective orthotopic liver transplantation.

Cited by 19 publications

References 14 publications

Partial splenectomy in cystic fibrosis patients with hypersplenism

Partial splenectomy in cystic fibrosis patients with hypersplenism

History of pediatric liver transplantation. Where are we coming from? Where do we stand?

Endovascular Management of Early Lung Transplant–Related Anastomotic Pulmonary Artery Stenosis

Contact Info

Product

Resources

About