Liver transplantation

Liver transplantation

Liver transplantation is the only therapy that treats portal hypertension and the underlying liver disease and may ulti mately be required in patents with variceal bleeding. Previous surgical shunts increase the complexity and morbidity of orthotopic liver transplantation and TIPSS should be the preferred management (see Chapter 89 ). Mitsuo Sugiura , 1925–1988, surgeon, University of Juntendo, Tokyo, Japan. (d) Summary box 69.10 - Management of bleeding oesophageal varices /uni25CF ). /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF

(c) or splenorenal (d) anastomoses. Blood transfusion Correct coagulopathy Oesophageal balloon tamponade (Sengstaken–Blakemore or Minnesota tube) Drug therapy (terlipressin) Endoscopic sclerotherapy or banding Assess portal vein patency (Doppler ultrasonography or CT) TIPSS Surgery Portosystemic shunts Splenectomy and gastric devascularisation Sugiura procedure