Metabolic Brain Disease

, Volume 22, Issue 1, pp 45–50 | Cite as

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
Original Paper


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.


Hepatic encephalopathy Venous ammonia levels Transjugular intrahepatic portosystemic shunt l-ornithine-l-aspartate Stent reduction 



hepatic encephalopathy


transjugular intrahepatic portosystemic shunt




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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Vanessa Stadlbauer
    • 1
    • 4
  • Josef Tauss
    • 2
  • Horst R. Portugaller
    • 2
  • Philipp Stiegler
    • 3
  • Florian Iberer
    • 3
  • Rudolf E. Stauber
    • 1
  1. 1.Department of Internal Medicine, Division of Gastroenterology and HepatologyMedical University of GrazGrazAustria
  2. 2.Department of Radiology, Division of Interventional RadiologyMedical University of GrazGrazAustria
  3. 3.Department of Surgery, Division of Transplantation SurgeryMedical University of GrazGrazAustria
  4. 4.Department of Medicine, Liver Failure Group, UCL Institute of HepatologyUniversity College LondonLondonUK

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