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J Hepatol. 2004 Jan;40(1):140-6.

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

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  • 1Liver Unit, Institute for Digestive Diseases, Hospital Clínic, University of Barcelona, Villarroel 170, Barcelona 08036, Catalunya, Spain.

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.

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PMID:
14672625
[PubMed - indexed for MEDLINE]
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