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J Hepatol. 2011 Aug;55(2):491-6. doi: 10.1016/j.jhep.2011.02.002. Epub 2011 Feb 18.

Continuous recurrence of type 1 hepatorenal syndrome and long-term treatment with terlipressin and albumin: a new exception to MELD score in the allocation system to liver transplantation?

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1
Department of Clinical and Experimental Medicine, University of Padova, Italy.

Abstract

BACKGROUND & AIMS:

The recurrence of type 1 hepatorenal syndrome has been described in up to 20% of responders to terlipressin and albumin after the discontinuation of the treatment. Subsequent recurrence of type 1 hepatorenal syndrome may require long-term treatment with terlipressin and albumin.

METHODS:

We describe our experience of long-term administration of terlipressin as a bridge to LT in three patients with cirrhosis and recurrent type 1 hepatorenal syndrome. For all three patients we requested an "early transplant" which is an option recognized in our country to reduce waiting times for liver transplantation.

RESULTS:

All three patients were transplanted within 2 months of onset of hepatorenal syndrome. All patients are still alive and none of them have developed chronic kidney disease.

CONCLUSIONS:

The outcomes of these patients suggest that long-term treatment with terlipressin and albumin is effective and well tolerated in patients with continuous recurrence of type 1 hepatorenal syndrome and, therefore, should be considered an absolute priority criterion in the allocation system for liver transplantation.

PMID:
21334405
DOI:
10.1016/j.jhep.2011.02.002
[Indexed for MEDLINE]
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