Effects of treatment of hepatorenal syndrome before transplantation on posttransplantation outcome. A case-control study.

Abstract

BACKGROUND:

Pretransplant renal function is the major determinant of survival after liver transplantation (LTx). Patients with hepatorenal syndrome (HRS) have a poor outcome after LTx compared with patients transplanted without HRS.

AIM:

To analyze the impact of treatment of HRS before LTx on outcome after transplantation.

METHODS:

The outcome of patients with HRS (n=9) treated with vasopressin analogues before LTx was compared with that of a contemporary control group of patients without HRS (n=27) matched by age, severity of liver failure, and type of immunosuppression.

RESULTS:

Cases and controls were similar with respect to pretransplantation characteristics. Three-year survival probability was similar between the two groups (HRS-treated: 100% vs control: 83%, P=0.15). No significant differences were found between the two groups with respect to the incidence of impairment of renal function after LTx (HRS-treated: 22% vs control: 30%), severe infections (22 vs 33%), acute rejection (33 vs 41%), days in Intensive Care Unit (6+/-1 vs 8+/-1), days in hospital (27+/-4 vs 31+/-4), and transfusion requirements (11+/-3 vs 10+/-2 units).

CONCLUSIONS:

Patients with HRS treated with vasopressin analogues before LTx have a posttransplantation outcome similar to that of patients transplanted with normal renal function. These results suggest that HRS should be treated before LTx.

• Authors: Tea Restuccia, Rolando Ortega, Monica Guevara, Pere Ginès, Carlo Alessandria, Osman Ozdogan, Miquel Navasa, Antoni Rimola, Juan Carlos Garcia-Valdecasas, Vicente Arroyo, Juan Rodés
• Journal: Journal of hepatology (J Hepatol) Vol. 40 Issue 1 Pg. 140-6 (Jan 2004) ISSN: 0168-8278 [Print] Netherlands
• PMID: 14672625 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Vasoconstrictor Agents
• Vasopressins
• Ornipressin
• Lypressin
• Terlipressin

Topics

• Case-Control Studies
• Female
• Hepatorenal Syndrome (drug therapy, physiopathology, surgery)
• Humans
• Kidney (physiopathology)
• Liver Failure (surgery)
• Liver Transplantation
• Lypressin (analogs & derivatives, therapeutic use)
• Male
• Middle Aged
• Ornipressin (therapeutic use)
• Postoperative Complications
• Postoperative Period
• Prognosis
• Survival Analysis
• Terlipressin
• Treatment Outcome
• Vasoconstrictor Agents (therapeutic use)
• Vasopressins (therapeutic use)