Aspen Webinar 2021 Part 6 -Complications and Mgt of End-Stage liver disease

More from Aspen Webinar 2021. This blog entry has abbreviated/summarized several presentations. Though not intentional, some important material is likely to have been omitted; in addition, transcription errors are possible as well. On the last day of this webinar conference, there were three more terrific lectures which addressed topics related to a a failing liver.

Key points:

  • Surgical options are based on primary etiology: pre-hepatic, intra-hepatic, and post-hepatic
  • Rex procedure is technically difficult but is preferred for pre-hepatic obstruction
  • Warren Shunt (distal splenorenal) and TIPS can be done for intrahepatic disease
  • Often difficulty in selecting patients for surgical shunting beyond refractory bleeding

Some slides:

Experience at Cincy with portal hypertension patients and shunting

Key points:

  • Hyperreflexia is a good indicator of stage 3 of HE
  • Patients with HE need to be managed in ICU
  • MARS is being used in some centers (even in infants)

Complications of ESLD -Kathy Campbell

This talk provided a good overview of complications including ascites, variceal bleeding, frailty & sarcopenia, and hepatopulmonary syndrome.