Can a blood test predict patients at risk for significant confusion and disorientation after a shunt through the liver?

Principal Investigator: Daniel Ganger, MD; Co-Principal Investigator: Justin R. Boike, MD Chronic liver disease remains a significant burden on society, despite the ability to treat and cure hepatitis C. With the growing obesity epidemic in the United States, fatty liver disease will soon overtake hepatitis C as the primary cause of chronic liver disease and cirrhosis. While liver transplantation offers a cure, it is not an option for many individuals who face complications of cirrhosis such excessive fluid retention and internal bleeding. Transjugular intrahepatic portosystemic shunt (TIPS) procedures offer an effective tool for treating these complications. In some patients, though, TIPS can worsen liver failure and sometimes cause debilitating confusion called hepatic encephalopathy. It is believed that excessive shunting of blood flow from the liver may be the culprit. In this study, the researchers will study the ability of a new laboratory test to measure the percentage of blood shunted away from the liver to better predict those patients at greatest risk for hepatic encephalopathy after a TIPS procedure. This tool could dramatically help guide the use of TIPS and promote earlier use of TIPS in low-risk...