Does Hepatorenal Syndrome Affect the Result of Liver Transplantation? Clinical Observations

• Published in: Transplantation proceedings Vol. 42; no. 7; pp. 2563 - 2566
• Main Authors: Park, I., Moon, E., Hwang, J.-A., Yu, S., Kim, B.-W., Wang, H.-J., Shin, G.-T., Kim, H.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.09.2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Creatinine - blood; Female; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Gastroenterology. Liver. Pancreas. Abdomen; Glomerular Filtration Rate; Hepatorenal Syndrome - mortality; Hepatorenal Syndrome - physiopathology; Hepatorenal Syndrome - surgery; Humans; International Normalized Ratio; Kidney Transplantation - mortality; Kidney Transplantation - physiology; Liver Cirrhosis - etiology; Liver Cirrhosis - surgery; Liver Function Tests; Liver Transplantation - adverse effects; Liver Transplantation - mortality; Liver, biliary tract, pancreas, portal circulation, spleen; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Patient Selection; Prothrombin Time; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Survival Rate; Tissue, organ and graft immunology; Kidney disease; Urinary system disease; Digestive system; Liver; Cardiovascular disease; Homotransplantation; Result; Medicine; Treatment; Surgery; Observation; Digestive diseases; Graft; Hepatorenal syndrome; Liver transplantation
• ISSN: 0041-1345; 1873-2623; 1873-2623
• DOI: 10.1016/j.transproceed.2010.04.049

Hepatorenal syndrome (HRS) is a reversible, functional renal failure that occurs in patients with advanced hepatic failure. However, the reported rates of complete recovery of renal function and patient survivals after orthotopic liver transplantation (OLT) are variable. The aim of this study was to compare the outcomes after OLT between patients with HRS and those without HRS (no-HRS). We established exclusion criteria to select study patients who underwent OLT in a single center between January 2005 and October 2008. The exclusion criteria included the following: (1) malignancy, (2) <18 years of age, (3) other than primary OLT, (4) ABO mismatch or hemophilia, (5) no liver cirrhosis, and (6) survival >1 month after OLT. We selected 71 subjects, including 8 HRS and 63 no-HRS patients. No significant differences were observed in the estimated glomerular filtration rate (eGFR) between the 2 groups except for a lower eGFR on the day of and 1 month after OLT in the HRS group: 108.3 ± 40.5 versus 31.4 ± 14.1 mL/min and 85.4 ± 15.0 versus 57.3 ± 12.1 mL/min ( P = .000 and P = .014, respectively). The renal function of 6/7 HRS patients who survived >1 year improved. The 1-year patient survival rate after OLT in HRS patients was similar to that without HRS: 95% versus 86% ( P = .37). We concluded that HRS had minimal effects on patient survival and return of acceptable renal function.