LIVER-TRANSPLANTATION FOLLOWING SHUNT OR TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC STENT-SHUNT

The goal of this study was to assess the influence of prior treatment of bleeding esophageal varices on liver transplantation. After sclerot herapy the results of liver transplantation were identical to those ac hieved in patients without previous variceal hemorrhage (74 % 1-year s urvival). The results of liver transplantation to patients who already had surgical shunts were dismal. Four of nine patients with portocava l or Warren shunts were long-term survivors. In comparison, the intrao perative course in five patients with transjugular intrahepatic portos ystemic stent shunts (TIPSS) was uneventful and four of these were lon g-term survivors. This has led us to adopt TIPSS as the treatment moda lity of choice for patients with bleeding varices awaiting liver trans plantation.