Liver Failure (TIPS)

Treatments for Liver Failure

VIR offers multiple treatments for liver failure, including medical therapy, the TIPS procedure, and BRTO, both of which can be performed at an Illinois Adventist hospital.

There are many causes of liver failure and end stage liver disease, including alcohol-related liver disease, hepatitis, metastatic tumors, and environmental exposures to toxins. Over time, the liver can become scarred and develop cirrhosis. Cirrhosis can cause blood pressure to build up in the abdomen leading to bleeding or fluid accumulation in the abdomen (ascites).

The TIPS Procedure

If medical therapy fails to be an effective liver failure treatment, a procedure called Transjugular Intrahepatic Portal-systemic Shunt (TIPS) can be performed. The traditional open surgical bypass has a 10-60 percent mortality (death risk). Procedure-related mortality due to TIPS procedures is rare.

This non-surgical treatment involves creating a bypass inside the liver using balloon angioplasty and stent-graft technology. X-ray guidance is used to find the correct vessels and to form a short pathway between them inside the liver. This relieves the high pressure in the veins and reverses the tendency for bleeding and fluid accumulation.

liver-stent

Here, a catheter carrying an expandable stent has been placed through the liver, non-surgically.

liver-stent

The stent is allowed to expand, creating a flow from high to low pressure veins, relieving portal hypertension

The TIPS procedure may be a bridge to liver transplantation in very sick patients. Some patients may be too ill to have the procedure however. Careful evaluation and consultation with other specialists regarding treatments for liver failure is performed in every case.

BRTO (Balloon-Occluded Retrograde Tranvenous Obliteration of Gastric varices)

This newer procedure treats a very difficult problem, related to liver cirrhosis and portal hypertension. When cirrhosis creates high pressure in abdominal veins, large varicose veins (gastric varices) may bulge into the stomach and cause deadly bleeding. In this procedure, the varicose veins are reached with an image guided catheter and a sclerosing liquid is pumped into them, stopping all blood flow. They then become obliterated over time, permanently reducing risk of bleeding.

Denver Shunt placement for abdominal Fluid accumulation

Some patients with liver failure may not be candidate for TIPS creation. When fluid builds up in the abdomen, and medical treatment fails to keep up, a Denver Shunt can be placed to allow the body to re-absorb the fluid and decrease water weight gain. The device returns the fluid directly to the patient’s veins, allowing them to keep precious proteins and other necessary things lost when fluid is drained out of the body and discarded. We place these shunts non-surgically, using image guidance, in appropriate patients.

If you or a loved one might be a candidate for a TIPS, or other treatments, ask your doctor. To schedule a clinic consultation,contact us for information regarding treatments for liver failure or call (630) 856-7460.

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