Dear David
The question is TIPS before Hematological stem cell transplantation (HSCT)
I am following many hematological patients before and after allogenic HSCT, being a coordinator of an italian multicenter study ( ELASTOVOD study ) on the use of liver stiffness in prediciting VOD after HSCT; in about 800 patients I have never seen perform TIPS before transplantation and in reality few italian centers insert TIPS also after HSCT to treat VOD ( even if in a recent paper by Ignacio Gomez-Centurion BBMT 2020, it seems be useful). However in your specific case ( TIPS before HSCT) considering the presence of PH and the high risk to develop VOD and other complication, I believe that to perform TIPS to reduce PH it might be an idea to consider ( no specific study have beeen carried out on this topic) and furthermore in the case of HSCT I could suggest to use also defibrotide in prophylaxis to prevent VOD
All the best
Antonio
Antonio Colecchia MD
Gastroenterology Unit,
Borgo Trento University-Hospital
Verona, Italy
antonio.colecchia@aovr.veneto.it
