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Transjugular Intrahepatic Portosystemic Shunt: Challenges and Perspectives—2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 15 June 2026 | Viewed by 518

Special Issue Editors


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Guest Editor
Department of Medical and Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, 00185 Rome, Italy
Interests: hepatic encephalopathy; minimal hepatic encephalopathy; spontaneous portal-systemic shunts; transjugular intrahepatic portosystemic shunt; cirrhosis; portal hypertension; sarcopenia
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
Interests: hepatic encephalopathy; minimal hepatic encephalopathy; spontaneous portal-systemic shunts; transjugular intrahepatic portosystemic shunt; cirrhosis; portal hypertension; sarcopenia

E-Mail Website
Guest Editor
Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy
Interests: liver cirrhosis; portal hypertension; variceal bleeding; ascites; hepatic encephalopathy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of “Transjugular Intrahepatic Portosystemic Shunt: Challenges and Perspectives” (https://www.mdpi.com/journal/jcm/special_issues/046Y1714X1).

Transjugular intrahepatic portosystemic shunts have been part of the therapeutic armamentarium for the resolution of complications related to portal hypertension for years. At first, its use was limited to patients with relapsed esophagogastric variceal hemorrhage or refractory ascites, but over the years, the indications have changed regarding the timing of the procedure, and it has also been extended to other indications, such as congestive transfusion-dependent gastropathy despite standard medical and endoscopic therapy, Budd–Chiari syndrome, and portal vein recanalization in the case of portal thrombosis, and it has also been used in selected cases of non-cirrhotic portal hypertension. The aim of this collection will be to provide a systematic and critical analysis of the state of the art, of the gray areas, and of the challenges and the treatment prospects of this procedure.

Dr. Lorenzo Ridola
Dr. Stefania Gioia
Dr. Silvia Nardelli
Guest Editors

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Keywords

  • hepatic encephalopathy
  • spontaneous portal-systemic shunts
  • transjugular intrahepatic portosystemic shunt
  • cirrhosis
  • portal hypertension
  • sarcopenia
  • myosteatosis
  • gastrointestinal bleeding
  • ascites
  • non cirrhotic portal hypertension

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Published Papers (1 paper)

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10 pages, 1189 KB  
Case Report
Shunt Surgery for Pediatric Prehepatic Portal Hypertension: A Single-Center Case Series
by Gabija Pikturnaitė, Austėja Račytė, Alina Rudokaitė, Gediminas Vaitėnas, Jonas Povilavičius, Benas Prušinskas, Ilona Dockienė, Marius Kurminas, Rūta Bernatavičienė and Gilvydas Verkauskas
J. Clin. Med. 2025, 14(21), 7780; https://doi.org/10.3390/jcm14217780 - 2 Nov 2025
Viewed by 441
Abstract
Background/Objectives: Management of prehepatic portal hypertension involves endoscopic and medical therapies with subsequent shunting if symptoms persist. Lately, surgical shunts, particularly the Meso-Rex shunt, are increasingly considered early in the disease course, offering benefits such as minimized hyperammonemia, improved somatic growth, and [...] Read more.
Background/Objectives: Management of prehepatic portal hypertension involves endoscopic and medical therapies with subsequent shunting if symptoms persist. Lately, surgical shunts, particularly the Meso-Rex shunt, are increasingly considered early in the disease course, offering benefits such as minimized hyperammonemia, improved somatic growth, and preservation of liver function. Our study evaluates post-operative outcomes after different surgical procedures in children with prehepatic portal hypertension. Methods: This single-centre retrospective case series included six children undergoing surgical shunting for prehepatic portal hypertension over a 5-year period. Medical records before and after surgery, followed for an average of 4.0 years, were analyzed. Results: Five patients underwent a Meso-Rex bypass, while one patient underwent a mesorenal shunt procedure. All cases showed clinically significant regression of esophageal varices six months post-surgery. Thrombocyte as well as leukocyte count significantly increased in five out of six patients during the long-term follow-up. Currently, five out of six surgically formed shunts (83%) continue to function normally. Conclusions: Our study supports early surgical intervention for improved long-term outcomes in managing portal hypertension, reducing complications like hypersplenism and variceal bleeding. Early consideration and ongoing monitoring are crucial for long-term success in children with portal hypertension. Full article
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