Impact of liver transplantation on the survival of patients treated for hepatorenal syndrome type 1.
Boyer TD, Sanyal AJ, et al.Liver Transplantation, 17(11): 1328-1332, 2011.
Aims
To evaluate the survival benefits of liver transplantation for patients with hepatorenal syndrome type 1 (HRS1).
Interventions
Intravenous terlipressin 1 mg every 6 hours versus a matching placebo.
Participants
99 patients with HRS1.
Outcomes
Transplant-free survival and overall survival rate.
Follow-up
180 days
CET Conclusions
The study confirms the poor prognosis of patients with HRS1 and that liver transplantation is the definitive treatment for eligible patients. The use of terlipressin plus albumin improved renal function and survival in those responding to treatment and who were unable to receive a transplant; but the survival of those patents who achieve reversal of their HRS is worse than survival of those receiving a liver transplant. The benefit of terlipressin in patients undergoing liver transplantation for HRS1 is due to the improvement in pretransplant renal function in all probability which should make post operative management easier in this group of patients.
Data analysis
Per protocol analysis
Trial registration
NCT00089570 (ClinicalTrials.gov)