Hepatic encephalopathy in a liver transplant recipient with stable liver function

Hepatology. 2013 Apr;57(4):1672-4. doi: 10.1002/hep.26298.

Abstract

Postshunt hepatic encephalopathy after liver transplantation (LT) is an infrequent condition and is commonly associated with portal occlusion or stenosis and the presence of a patent portosystemic shunt. Portal vein stenosis (PVS) or thrombosis (PVT) are uncommon complications after LT. The overall frequency of both complications is reported to be less than 3%. When PVS or PVT develop early after LT, the occlusion of the portal vein can have catastrophic consequences to the graft including acute liver failure and graft loss. Late PVT/PVS are asymptomatic in approximately 50% of the cases and mainly diagnosed by a routine ultrasound. Symptomatic postshunt hepatic encephalopathy (HE) is a very infrequent condition after LT that has been scarcely reported in the literature. We present here the case of a liver recipient with normal graft function who presented with hepatic encephalopathy 3 months after LT with stable liver function but a severe portal stenosis and the presence of a spontaneous portosystemic shunt whose successful endovascular treatment was followed by the complete resolution of the HE.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Constriction, Pathologic / complications
  • Constriction, Pathologic / physiopathology
  • Constriction, Pathologic / surgery
  • Endovascular Procedures
  • Hepatic Encephalopathy / diagnosis*
  • Hepatic Encephalopathy / etiology
  • Humans
  • Liver / physiology*
  • Liver Cirrhosis / surgery
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Portal System / physiopathology*
  • Treatment Outcome