PORTACAVAL SHUNT IN HYPERLIPOPROTEINÆMIA

Thomas E. Starzl; Charles W. Putnam; H. Peter Chase; Kendrick A. Porter

doi:10.1016/S0140-6736(73)92599-3

PORTACAVAL SHUNT IN HYPERLIPOPROTEINÆMIA

Thomas E. Starzl
, Charles W. Putnam
, H. Peter Chase
, Kendrick A. Porter

Research output: Contribution to journal › Article › peer-review

122 Scopus citations

Abstract

A 12-year-old girl with homozygous type-II hyperlipoproteinæmia, which was refractory to medical treatment, had significant improvement in her serum lipid abnormalities during a trial of parenteral hyperalimentation. Subsequently, end-to-side portacaval shunt caused striking reduction of the serum-cholesterol and low-density (beta) lipoprotein elevations, regression or disappearance of xanthomatous skin and tendinous lesions during the 61/2 months since operation, and relief of severe cardiac symptoms apparently as resorption occurred of xanthomatous deposits in the aortic valve and around the coronary arteries. Liver biopsy at 51/2 months showed several changes, including depletion of rough endoplasmic reticulum; this finding was consistent with the possibility that the portal diversion caused the desired therapeutic effects by inhibiting synthesis of hepatic cholesterol or low-density lipoprotein.

Original language	English (US)
Pages (from-to)	940-944
Number of pages	5
Journal	The Lancet
Volume	302
Issue number	7835
DOIs	https://doi.org/10.1016/S0140-6736(73)92599-3
State	Published - Oct 27 1973
Externally published	Yes

ASJC Scopus subject areas

General Medicine

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title = "PORTACAVAL SHUNT IN HYPERLIPOPROTEIN{\AE}MIA",

abstract = "A 12-year-old girl with homozygous type-II hyperlipoprotein{\ae}mia, which was refractory to medical treatment, had significant improvement in her serum lipid abnormalities during a trial of parenteral hyperalimentation. Subsequently, end-to-side portacaval shunt caused striking reduction of the serum-cholesterol and low-density (beta) lipoprotein elevations, regression or disappearance of xanthomatous skin and tendinous lesions during the 61/2 months since operation, and relief of severe cardiac symptoms apparently as resorption occurred of xanthomatous deposits in the aortic valve and around the coronary arteries. Liver biopsy at 51/2 months showed several changes, including depletion of rough endoplasmic reticulum; this finding was consistent with the possibility that the portal diversion caused the desired therapeutic effects by inhibiting synthesis of hepatic cholesterol or low-density lipoprotein.",

author = "Starzl, \{Thomas E.\} and Putnam, \{Charles W.\} and Chase, \{H. Peter\} and Porter, \{Kendrick A.\}",

note = "Funding Information: We thank Sir Macfarlane Burnet, Prof. G. J. V. Nossal, and Dr I. J. Wood for advice; Dr A. Basten, Dr C. Hosking, and Dr D. Jose for samples of blood from children with immunodeficiency diseases; Mr P. Clarke and Mr I. McDonald for thymic tissue; Mr J. Pye for iodinating antigens; Prof. G. L. Ada for hasmocyanin; and Mr J. Buckley for help with statistical methods. This work was supported by the National Health and Medical Research Council of Australia.",

year = "1973",

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doi = "10.1016/S0140-6736(73)92599-3",

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AU - Starzl, Thomas E.

AU - Putnam, Charles W.

AU - Chase, H. Peter

AU - Porter, Kendrick A.

N1 - Funding Information: We thank Sir Macfarlane Burnet, Prof. G. J. V. Nossal, and Dr I. J. Wood for advice; Dr A. Basten, Dr C. Hosking, and Dr D. Jose for samples of blood from children with immunodeficiency diseases; Mr P. Clarke and Mr I. McDonald for thymic tissue; Mr J. Pye for iodinating antigens; Prof. G. L. Ada for hasmocyanin; and Mr J. Buckley for help with statistical methods. This work was supported by the National Health and Medical Research Council of Australia.

PY - 1973/10/27

Y1 - 1973/10/27

N2 - A 12-year-old girl with homozygous type-II hyperlipoproteinæmia, which was refractory to medical treatment, had significant improvement in her serum lipid abnormalities during a trial of parenteral hyperalimentation. Subsequently, end-to-side portacaval shunt caused striking reduction of the serum-cholesterol and low-density (beta) lipoprotein elevations, regression or disappearance of xanthomatous skin and tendinous lesions during the 61/2 months since operation, and relief of severe cardiac symptoms apparently as resorption occurred of xanthomatous deposits in the aortic valve and around the coronary arteries. Liver biopsy at 51/2 months showed several changes, including depletion of rough endoplasmic reticulum; this finding was consistent with the possibility that the portal diversion caused the desired therapeutic effects by inhibiting synthesis of hepatic cholesterol or low-density lipoprotein.

AB - A 12-year-old girl with homozygous type-II hyperlipoproteinæmia, which was refractory to medical treatment, had significant improvement in her serum lipid abnormalities during a trial of parenteral hyperalimentation. Subsequently, end-to-side portacaval shunt caused striking reduction of the serum-cholesterol and low-density (beta) lipoprotein elevations, regression or disappearance of xanthomatous skin and tendinous lesions during the 61/2 months since operation, and relief of severe cardiac symptoms apparently as resorption occurred of xanthomatous deposits in the aortic valve and around the coronary arteries. Liver biopsy at 51/2 months showed several changes, including depletion of rough endoplasmic reticulum; this finding was consistent with the possibility that the portal diversion caused the desired therapeutic effects by inhibiting synthesis of hepatic cholesterol or low-density lipoprotein.

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JO - The Lancet

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ER -

PORTACAVAL SHUNT IN HYPERLIPOPROTEINÆMIA

Abstract

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