Conventional Liver Retransplantation with Caval Replacement for Suprahepatic Inferior Vena Cava Stenosis Secondary to a Malpositioned TIPS: A Case Report.
Maciana Santos Silva, Daniel Reis Waisberg, Vinicius Rocha-Santos et al.
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Case in brief
A 64-year-old male with alcoholic cirrhosis and a history of TIPS placement developed refractory ascites and hepatic encephalopathy, leading to liver transplantation. During the procedure, extensive pericaval fibrosis was found due to a malpositioned TIPS, necessitating venoplasty and caval replacement. The patient experienced primary non-function and required retransplantation, which successfully resolved the complications.
What made this case unusual
The case highlights the significant surgical challenges posed by extensive fibrosis and anatomical changes from a long-standing malpositioned TIPS, which is rarely reported in the context of liver transplantation.
Diagnostic / clinical pearl
Clinicians should be aware that long-term malpositioned TIPS can lead to significant anatomical alterations, complicating liver transplantation and necessitating specialized surgical approaches.
Why it matters
Understanding the implications of TIPS-related changes is crucial for transplant teams to anticipate and manage potential complications effectively during liver transplantation.