Document Detail


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?
MedLine Citation:
PMID:  21334405     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Salvatore Piano; Filippo Morando; Silvano Fasolato; Marta Cavallin; Novella Boscato; Patrizia Boccagni; Giacomo Zanus; Umberto Cillo; Angelo Gatta; Paolo Angeli
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2011-02-18
Journal Detail:
Title:  Journal of hepatology     Volume:  55     ISSN:  1600-0641     ISO Abbreviation:  J. Hepatol.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-18     Completed Date:  2011-11-21     Revised Date:  2012-08-24    
Medline Journal Info:
Nlm Unique ID:  8503886     Medline TA:  J Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  491-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Clinical and Experimental Medicine, University of Padova, Italy.
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MeSH Terms
Descriptor/Qualifier:
Albumins / administration & dosage*
End Stage Liver Disease / complications,  surgery
Hepatorenal Syndrome / drug therapy*,  physiopathology,  surgery*
Humans
Liver Cirrhosis, Alcoholic / complications,  surgery
Liver Transplantation*
Lypressin / administration & dosage,  analogs & derivatives*
Male
Middle Aged
Recurrence
Time Factors
Treatment Outcome
Vasoconstrictor Agents / administration & dosage*
Chemical
Reg. No./Substance:
0/Albumins; 0/Vasoconstrictor Agents; 14636-12-5/terlipressin; 50-57-7/Lypressin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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