Metabolic Brain Disease 2007-03-01

Hepatic encephalopathy following transjugular intrahepatic portosystemic shunt (TIPS): management with L-ornithine-L-aspartate and stent reduction.

Vanessa Stadlbauer, Josef Tauss, Horst R Portugaller, Philipp Stiegler, Florian Iberer, Rudolf E Stauber

Index: Metab. Brain Dis. 22(1) , 45-50, (2007)

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Abstract

Hepatic encephalopathy (HE) is a common problem after insertion of a trans-jugular intrahepatic portosystemic shunt (TIPS), which may be difficult to manage. We present a case of severe post-TIPS HE unresponsive to high doses of L-ornithine-L-aspartate (LOLA) despite reduction of venous ammonia levels in a dose-dependent fashion. Ultimately, high-grade HE was successfully treated by a reduction stent and the patient subsequently underwent successful liver transplantation.