Ep. 473 Portal Hypertension Treatment Strategies: IR and Hepatology Perspectives with Dr. Thomas Leventhal and Dr. Siobhan Flanagan
Aug 13, 2024
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Dr. Thomas Leventhal, an Associate Professor of Transplant Hepatology, and Dr. Siobhan Flanagan, an Associate Professor of Interventional Radiology, discuss the collaborative evolution in managing portal hypertension. They emphasize the significance of teamwork in complex liver conditions, particularly through TIPS procedures. Insights into current best practices, including patient assessment and biopsy challenges, are shared. Looking ahead, they explore groundbreaking advancements like stem cells and lab-grown organs, which could transform transplant outcomes and reduce immunosuppression.
Strong collaboration between interventional radiology and hepatology is essential for optimizing patient care in portal hypertension management.
Effective patient selection and timely referrals for procedures like TIPS can greatly improve outcomes for those with advanced liver disease.
Innovative advancements in organ regeneration and treatment protocols are promising for the future management of portal hypertension and liver diseases.
Deep dives
Advancements in Organ Regeneration
Innovative companies are currently developing techniques to grow human organs, such as kidneys and livers, using bioreactors. This groundbreaking process aims to eventually produce organs suitable for transplantation, eliminating the need for immunosuppression post-surgery. Researchers are focusing on utilizing cellular technology, allowing for the cultivation of organs that are genetically matched to patients, thereby reducing complications and rejection rates. This advancement marks a significant shift in organ transplantation, moving closer to turning what once seemed like science fiction into reality.
Collaboration Between Specialties
A strong collaboration between interventional radiology and hepatology is crucial for improving patient care and outcomes, particularly for those suffering from portal hypertension. Regular multidisciplinary meetings and open lines of communication have been established to facilitate better patient management and decision-making. By sharing insights on complex cases, the two specialties ensure that patients receive timely interventions, leading to increased success rates in treatments like TIPS procedures. Such partnerships exemplify the importance of teamwork in modern medicine to enhance clinical results.
Patient Selection and Referral Processes
Effective patient selection for interventional procedures like TIPS is a key concern in managing portal hypertension. Hepatologists often act as gatekeepers, ensuring that patients with cirrhosis and related conditions are referred to interventional radiology at the appropriate time for potential interventions. Factors such as medical history, the urgency of the situation, and the patient's response to current medications significantly influence referral decisions. Timely referrals can significantly impact patient outcomes, especially for those experiencing complications from advanced liver disease.
Post-Procedure Management and Follow-Up
Following TIPS procedures, patients often benefit from a structured post-operative management protocol that includes regular follow-ups. These visits allow healthcare professionals to monitor potential complications, such as hepatic encephalopathy, while ensuring that patients receive the necessary support and medications. Dedicated nursing staff are involved in follow-up care, providing patients with essential information and resources to manage their recovery effectively. This comprehensive approach has been shown to improve patient outcomes and enhance their overall quality of life.
The Future of Portal Hypertension Management
Looking ahead, there is considerable excitement surrounding the future advancements in managing portal hypertension, particularly with ongoing research into organ regeneration and improved treatment protocols. New clinical studies and collaborations between different medical specialties are paving the way for more efficient and effective treatments. Additionally, the development of better diagnostic tools and intervention techniques may lead to enhanced patient care. This rapidly evolving field holds promise for significant improvements in the quality of life for patients suffering from liver diseases and related complications.
The management of portal hypertension has drastically evolved over the years. What are the current best practices? And what’s coming next? Dr. Tom Leventhal and Dr. Siobahn Flanagan from University of Minnesota Medical School join us for an interdisciplinary discussion. Dr. Leventhal is an Associate Professor of Transplant Hepatology and Dr. Siobhan is an Associate Professor of Interventional Radiology.
The doctors discuss current collaborative approaches that are improving portal hypertension patient care, the impact of contemporary clinical practices in transplant hepatology and IR, and the imminent future of portal hypertension treatments. Dr. Leventhal also gives his insight on what could be on the horizon, touching on in-vitro organ creation, xenotransplants, and stem cells phasing out immunosuppression.
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TIMESTAMPS
00:00 - Introduction
06:10 - Managing Portal Hypertension
07:51 - Current Collaborative Practices
10:38 - Patient Referral and Management
15:25 - Initial Workup for Portal Hypertension
19:27 - Role of Biopsy in Diagnosis
24:02 - Patient Scenarios for TIPS Referral
32:04 - Ultrasound and Intracardiac Echocardiography (ICE) in TIPS
38:09 - Clinical Management
52:48 - Future of Transplant and Organ Growth
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