{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:25:14Z","timestamp":1789230314904,"version":"build-2803163510"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010065","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000}}],"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Transjugular intrahepatic portosystemic shunt (TIPS) and shunt surgery are established treatment options for portal hypertension, but have not been systematically evaluated in patients with portal hypertension due to hepatosplenic schistosomiasis (HSS), one of the neglected tropical diseases with major impact on morbidity and mortality in endemic areas.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>In this retrospective case study, patients with chronic portal hypertension due to schistosomiasis treated with those therapeutic approaches in four tertiary referral hospitals in Germany and Italy between 2012 and 2020 were included. We have summarized pre-interventional clinical data, indication, technical aspects of the interventions and clinical outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Findings<\/jats:title>\n<jats:p>Overall, 13 patients with confirmed HSS were included. 11 patients received TIPS for primary or secondary prophylaxis of variceal bleeding due to advanced portal hypertension and failure of conservative management. In two patients with contraindications for TIPS or technically unsuccessful TIPS procedure, proximal splenorenal shunt surgery in combination with splenectomy was conducted. During follow-up (mean follow-up 23 months, cumulative follow-up time 31 patient years) no bleeding events were documented. In five patients, moderate and transient episodes of overt hepatic encephalopathy were observed. In one patient each, liver failure, portal vein thrombosis and catheter associated sepsis occurred after TIPS insertion. All complications were well manageable and had favorable outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>TIPS implantation and shunt surgery are safe and effective treatment options for patients with advanced HSS and sequelae of portal hypertension in experienced centers, but require careful patient selection.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010065","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T18:50:04Z","timestamp":1640112604000},"page":"e0010065","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["TIPS and splenorenal shunt for complications of portal hypertension in chronic hepatosplenic schistosomiasis\u2013A case series and review of the literature"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1936-8409","authenticated-orcid":true,"given":"Tamara","family":"Nordmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7797-3674","authenticated-orcid":true,"given":"Stefan","family":"Schlabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6755-4492","authenticated-orcid":true,"given":"Torsten","family":"Feldt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Gobbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-1079","authenticated-orcid":true,"given":"Andreas","family":"Krieg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes G.","family":"Bode","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6906-2598","authenticated-orcid":true,"given":"Andre","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Kraef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-9956","authenticated-orcid":true,"given":"Michael","family":"Praktiknjo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7028-3881","authenticated-orcid":true,"given":"Jonel","family":"Trebicka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9259-1885","authenticated-orcid":true,"given":"Michael","family":"Ramharter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marylyn M.","family":"Addo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Strassburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansgar W.","family":"Lohse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Luedde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-8461","authenticated-orcid":true,"given":"Stefan","family":"Schmiedel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3053-6730","authenticated-orcid":true,"given":"Hans Martin","family":"Orth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"pntd.0010065.ref001","volume-title":"Schistosomiasis: progress report 2001\u20132011","author":"World Health Organization","year":"2013"},{"issue":"1","key":"pntd.0010065.ref002","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/s41572-018-0013-8","article-title":"Schistosomiasis","volume":"4","author":"DP McManus","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"10258","key":"pntd.0010065.ref003","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"GBD 2019 Diseases and Injuries Collaborators","year":"2020","journal-title":"Lancet"},{"issue":"2\u20133","key":"pntd.0010065.ref004","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0001-706X(03)00029-9","article-title":"Quantification of clinical morbidity associated with schistosome infection in sub-Saharan Africa","volume":"86","author":"MJ van der Werf","year":"2003","journal-title":"Acta Trop"},{"issue":"2","key":"pntd.0010065.ref005","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1002\/path.1700090211","article-title":"C. Note on a new form of liver cirrhosis due to the presence of the ova of Bilharzia h\u00e6matobia","volume":"9","author":"Symmers W. St","year":"1904","journal-title":"J. Pathol. Bacteriol"},{"key":"pntd.0010065.ref006","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1002\/path.1700870202","article-title":"An experimental study of the pathogenesis and reversibility of schistosomal hepatic fibrosis","volume":"87","author":"GR Cameron","year":"1964","journal-title":"J Pathol Bacteriol"},{"issue":"3","key":"pntd.0010065.ref007","doi-asserted-by":"crossref","first-page":"425","DOI":"10.4269\/ajtmh.1971.20.425","article-title":"Alterations of the intrahepatic vasculature in hepatosplenic schistosomiasis mansoni","volume":"20","author":"ZA Andrade","year":"1971","journal-title":"Am J Trop Med Hyg"},{"issue":"16","key":"pntd.0010065.ref008","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1056\/NEJMra012396","article-title":"Schistosomiasis","volume":"346","author":"AG Ross","year":"2002","journal-title":"N Engl J Med"},{"issue":"6","key":"pntd.0010065.ref009","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1136\/gut.27.6.734","article-title":"Hepatosplenic schistosomiasis: a clinical review","volume":"27","author":"KM De Cock","year":"1986","journal-title":"Gut"},{"issue":"4","key":"pntd.0010065.ref010","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1046\/j.1365-3083.1997.d01-136.x","article-title":"Cytokine regulation of human immune response to Schistosoma mansoni: analysis of the role of IL-4, IL-5 and IL-10 on peripheral blood mononuclear cell responses.","volume":"46","author":"LC Malaquias","year":"1997","journal-title":"Scand J Immunol"},{"issue":"1","key":"pntd.0010065.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/S0037-86821991000100001","article-title":"Genetic predisposition to high infections in an endemic area of Schistosoma mansoni.","volume":"24","author":"L Abel","year":"1991","journal-title":"Rev Soc Bras Med Trop"},{"issue":"2\u20133","key":"pntd.0010065.ref012","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S0001-706X(03)00032-9","article-title":"The impact of chemotherapy on morbidity due to schistosomiasis","volume":"86","author":"J. Richter","year":"2003","journal-title":"Acta Trop"},{"issue":"1","key":"pntd.0010065.ref013","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1155\/1998\/68394","article-title":"Band ligation or sclerotherapy as endoscopic treatment for oesophageal varices in schistosomotic patients: results of a randomized study","volume":"11","author":"ES Siqueira","year":"1998","journal-title":"HPB Surg"},{"issue":"2","key":"pntd.0010065.ref014","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/hep.1840200220","article-title":"Portal hypertension in schistosomiasis: a long-term follow-up of a randomized trial comparing three types of surgery","volume":"20","author":"S Raia","year":"1994","journal-title":"Hepatology"},{"issue":"3","key":"pntd.0010065.ref015","doi-asserted-by":"crossref","first-page":"e0009191","DOI":"10.1371\/journal.pntd.0009191","article-title":"Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature","volume":"15","author":"F Tamarozzi","year":"2021","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0010065.ref016","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis","volume":"69","author":"European Association for the Study of the Liver","year":"2018","journal-title":"J Hepatol"},{"key":"pntd.0010065.ref017","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/978-3-642-57116-9_22","volume-title":"Portal Hypertension. Diagnostic Imaging and Imaging-Guided Therapy","author":"RF Dondelinger","year":"2000"},{"issue":"6","key":"pntd.0010065.ref018","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1007\/s11938-007-0050-y","article-title":"Hepatic schistosomiasis","volume":"10","author":"KL Andersson","year":"2007","journal-title":"Curr Treat Options Gastroenterol"},{"issue":"6","key":"pntd.0010065.ref019","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/S1473-3099(15)70009-5","article-title":"Severe liver fibrosis caused by Schistosoma mansoni: management and treatment with a transjugular intrahepatic portosystemic shunt.","volume":"15","author":"J Richter","year":"2015","journal-title":"Lancet Infect Dis"},{"issue":"7","key":"pntd.0010065.ref020","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1097\/MCG.0000000000000545","article-title":"Portal Hypertension Related to Schistosomiasis Treated With a Transjugular Intrahepatic Portosystemic Shunt.","volume":"50","author":"S Grieco","year":"2016","journal-title":"J Clin Gastroenterol"},{"key":"pntd.0010065.ref021","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.tmaid.2019.01.006","article-title":"Transjugular Intrahepatic Portosystemic Shunt (TIPS) for primary and secondary prophylaxis of variceal bleeding in hepatic schistosomiasis","volume":"30","author":"C Kraef","year":"2019","journal-title":"Travel Med Infect Dis"},{"issue":"12","key":"pntd.0010065.ref022","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1007\/s00270-019-02295-6","article-title":"Transjugular Intrahepatic Portosystemic Shunt Placement in Patients with Schistosomiasis-Induced Liver Fibrosis","volume":"42","author":"J Liu","year":"2019","journal-title":"Cardiovasc Intervent Radiol"},{"key":"pntd.0010065.ref023","unstructured":"Deutsche Gesellschaft f\u00fcr Tropenmedizin. S1-Leitlinie 042\u2013005 \u201eDiagnostik und Therapie der Schistosomiasis (Bilharziose). 2017. Available from: https:\/\/www.awmf.org\/leitlinien\/detail\/ll\/042-005.html (as of July 20, 2021)"},{"issue":"3","key":"pntd.0010065.ref024","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension","volume":"63","author":"R De Franchis","year":"2015","journal-title":"J Hepatol"},{"issue":"1","key":"pntd.0010065.ref025","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jhep.2015.07.040","article-title":"EASL Clinical Practice Guidelines: Vascular diseases of the liver","volume":"64","author":"European Association for the Study of the Liver","year":"2016","journal-title":"J Hepatol"},{"key":"pntd.0010065.ref026","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.mcp.2016.12.003","article-title":"Serological approaches for the diagnosis of schistosomiasis\u2014A review","volume":"31","author":"R Hinz","year":"2017","journal-title":"Mol Cell Probes"},{"issue":"5","key":"pntd.0010065.ref027","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1080\/00034983.1994.11812896","article-title":"Propranolol reduces mortality in patients with portal hypertension secondary to schistosomiasis","volume":"88","author":"H El Tourabi","year":"1994","journal-title":"Ann Trop Med Parasitol"},{"issue":"4","key":"pntd.0010065.ref028","doi-asserted-by":"crossref","first-page":"832","DOI":"10.4269\/ajtmh.19-0452","article-title":"Propranolol Reduces Portal Vein Diameter in Schistosomal Liver Disease with Portal Hypertension: A Prospective Cohort Study","volume":"102","author":"E Sinkala","year":"2020","journal-title":"Am J Trop Med Hyg"},{"issue":"5","key":"pntd.0010065.ref029","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.jhep.2014.01.015","article-title":"Covered vs. uncovered stents for transjugular intrahepatic portosystemic shunt: a randomized controlled trial","volume":"60","author":"JM Perarnau","year":"2014","journal-title":"J Hepatol"},{"issue":"6","key":"pntd.0010065.ref030","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.jhep.2019.12.021","article-title":"Total area of spontaneous portosystemic shunts independently predicts hepatic encephalopathy and mortality in liver cirrhosis","volume":"72","author":"M Praktiknjo","year":"2020","journal-title":"J Hepatol"},{"issue":"6","key":"pntd.0010065.ref031","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.2214\/AJR.13.12232","article-title":"Characterization of liver function parameter alterations after transjugular intrahepatic portosystemic shunt creation and association with early mortality","volume":"203","author":"LC Casadaban","year":"2014","journal-title":"AJR Am J Roentgenol"},{"issue":"1","key":"pntd.0010065.ref032","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/hep.510230105","article-title":"The hematologic consequences of transjugular intrahepatic portosystemic shunts","volume":"23","author":"AJ Sanyal","year":"1996","journal-title":"Hepatology"},{"issue":"4","key":"pntd.0010065.ref033","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.clinre.2019.09.006","article-title":"Mechanical hemolysis after transjugular intrahepatic portosystemic shunt can occur with covered stent","volume":"44","author":"J Dumortier","year":"2020","journal-title":"Clin Res Hepatol Gastroenterol"},{"issue":"Suppl 4","key":"pntd.0010065.ref034","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1590\/S0074-02761987000800008","article-title":"Comparison of pathologic changes in mammalian hosts infected with Schistosoma mansoni, S. japonicum and S. haematobium","volume":"82","author":"AW Cheever","year":"1987","journal-title":"Mem Inst Oswaldo Cruz"},{"issue":"5","key":"pntd.0010065.ref035","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.arcmed.2005.04.003","article-title":"Hypersplenism in schistosomatic portal hypertension","volume":"36","author":"A Petroianu","year":"2005","journal-title":"Arch Med Res"},{"issue":"5","key":"pntd.0010065.ref036","first-page":"382","article-title":"Splenic autotransplantation for treatment of portal hypertension","volume":"48","author":"A Petroianu","year":"2005","journal-title":"Can J Surg"},{"issue":"1","key":"pntd.0010065.ref037","doi-asserted-by":"crossref","first-page":"e000641","DOI":"10.1136\/bmjgast-2021-000641","article-title":"Economic evaluation of covered stents for transjugular intrahepatic portosystemic stent shunt in patients with variceal bleeding and refractory ascites secondary to cirrhosis","volume":"8","author":"R Mattock","year":"2021","journal-title":"BMJ Open Gastroenterol"},{"issue":"12","key":"pntd.0010065.ref038","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1016\/j.jvir.2018.08.019","article-title":"Cost-Effectiveness of Transjugular Intrahepatic Portosystemic Shunt versus Large-Volume Paracentesis in Refractory Ascites: Results of a Markov Model Incorporating Individual Patient-Level Meta-Analysis and Nationally Representative Cost Data","volume":"29","author":"SW Kwan","year":"2018","journal-title":"J Vasc Interv Radiol"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0010065","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T00:00:00Z","timestamp":1641254400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,4]],"date-time":"2022-01-04T18:34:06Z","timestamp":1641321246000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010065"}},"subtitle":[],"editor":[{"given":"Keke C.","family":"Fairfax","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,21]]},"references-count":38,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010065","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0010065","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,21]]}}}