Reply to Role of Echocardiography in detecting portopulmonary hypertension in liver transplant candidates

✍ Scribed by M. George DeBusk; Yoogoo Kang; Cataldo Doria; Victor J. Navarro; Ignazio R. Marino; Howard R. Doyle

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 60 KB
• Volume: 9
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.500090921

✦ Synopsis

In our series, 7,8 nine patients underwent OLT at 11.6 Ϯ 6.5 months (range, 0.9 to 20.2 months) after TIPS placement without major technical problems, although in two cases, dislocation of the stent into the portal vein required a careful surgical dissection. In particular, four of nine patients who underwent OLT had a stent reaching the IVC junction, and in one of these patients, because of hepatic vein stenosis, a second additional stent has been necessary to prolong the shunt up to the IVC. However, the surgeon encountered no difficulties when the stent reached the IVC junction because the covered portion of the stent was not attached to the liver parenchyma and was easily displaced for clamping. Histopathologic analyses of explanted Viatorr stent-grafts showed patent stentgrafts lined internally with a thin layer of fibrin. No signs of endothelialization were observed in the covered portion of the stent-grafts, and the stents were removed easily from the liver parenchyma. Instead, the uncovered portion of the stents was well attached to the portal vein wall. Therefore, when covered stents are used, the need to cover up