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Hepatic encephalopathy following transjugular intrahepatic portosystemic shunt (TIPS): Management with l-ornithine-l-aspartate and stent reduction

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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.

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Abbreviations

HE:

hepatic encephalopathy

TIPS:

transjugular intrahepatic portosystemic shunt

LOLA:

l-ornithine-l-aspartate

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria

    Vanessa Stadlbauer & Rudolf E. Stauber

  2. Department of Radiology, Division of Interventional Radiology, Medical University of Graz, Graz, Austria

    Josef Tauss & Horst R. Portugaller

  3. Department of Surgery, Division of Transplantation Surgery, Medical University of Graz, Graz, Austria

    Philipp Stiegler & Florian Iberer

  4. Department of Medicine, Liver Failure Group, UCL Institute of Hepatology, University College London, 69-75 Chenies Mews, London, WC1E 6HX, UK

    Vanessa Stadlbauer

Authors
  1. Vanessa Stadlbauer
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  2. Josef Tauss
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  3. Horst R. Portugaller
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  4. Philipp Stiegler
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  5. Florian Iberer
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  6. Rudolf E. Stauber
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Correspondence to Vanessa Stadlbauer.

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Stadlbauer, V., Tauss, J., Portugaller, H.R. et al. Hepatic encephalopathy following transjugular intrahepatic portosystemic shunt (TIPS): Management with l-ornithine-l-aspartate and stent reduction. Metab Brain Dis 22, 45–50 (2007). https://doi.org/10.1007/s11011-006-9032-3

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  • DOI: https://doi.org/10.1007/s11011-006-9032-3

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