Treatment of type 2 hepatorenal syndrome in patients awaiting transplantation: Effects on kidney function and transplantation outcomes.

Abstract

There is little information on the effects of treatment with vasoconstrictors plus albumin in patients with type 2 hepatorenal syndrome (HRS), particularly those awaiting liver transplantation (LT). This study reports the effects of treatment of type 2 HRS in patients on the waiting list for LT. We included 56 patients with type 2 HRS who were awaiting LT. Out of these 56 patients, 31 were treated with terlipressin and albumin. Nineteen (61%) of these 31 patients had response to therapy, and 11 of them relapsed after treatment withdrawal. There were no differences in mortality on the waiting list between responders and nonresponders. Among the 46 (82%) patients who underwent transplantation, 15 underwent transplantation with reversal of type 2 HRS, whereas the remaining 31 underwent transplantation with type 2 HRS. There were no significant differences in serum creatinine or estimated glomerular filtration rate between the 2 cohorts of patients at 3, 6, and 12 months after transplantation. There were no significant differences regarding development of acute kidney injury, need for renal replacement therapy, frequency of chronic kidney disease 1 year after transplant, length of hospitalization, and survival. In conclusion, treatment of patients with type 2 HRS with terlipressin and albumin does not appear to have beneficial effects either in pretransplantation or in posttransplantation outcomes.

• Authors: Ezequiel Rodriguez, Gustavo Henrique Pereira, Elsa Solà, Chiara Elia, Rogelio Barreto, Elisa Pose, Jordi Colmenero, Javier Fernandez, Miquel Navasa, Vicente Arroyo, Pere Ginès
• Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 21 Issue 11 Pg. 1347-54 (Nov 2015) ISSN: 1527-6473 [Electronic] United States
• PMID: 26178066 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 American Association for the Study of Liver Diseases.

Chemical References

• Albumins
• Vasoconstrictor Agents
• Lypressin
• Terlipressin
• Creatinine

Topics

• Albumins (administration & dosage)
• Creatinine (blood)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Glomerular Filtration Rate (drug effects)
• Hepatorenal Syndrome (diagnosis, drug therapy, mortality)
• Humans
• Injections, Intravenous
• Kidney Function Tests
• Liver Transplantation
• Lypressin (administration & dosage, analogs & derivatives)
• Male
• Middle Aged
• Prospective Studies
• Severity of Illness Index
• Spain (epidemiology)
• Survival Rate (trends)
• Terlipressin
• Treatment Outcome
• Vasoconstrictor Agents (administration & dosage)
• Waiting Lists
• Watchful Waiting (methods)