BACKGROUND: Studies suggest that terlipressin is effective in the treatment of hepatorenal syndrome (HRS). However, factors predicting response to therapy and the long-term outcome of patients have not been defined. METHODS: We reviewed all patients from our institution treated with terlipressin between July 1, 2001 and December 31, 2005 for HRS. Follow up continued until June 30, 2006. HRS was defined according to the International Ascites Club. The following data were retrieved: age, gender, etiology of liver disease, Child-Pugh score, HRS precipitant, therapy duration, creatinine at day 0 and end of treatment, adverse events, and patient outcome. RESULTS: Sixty-nine patients were included. Forty-nine episodes (71%) of HRS were type 1, and 20 episodes (29%) type 2. Forty-one (59.4%) patients responded to terlipressin. Two variables predicted renal function improvement: type 1 HRS and age. Twenty-one (30.4%) patients survived; 17 (81%) had type 1 HRS while four (19%) had type 2 HRS (P = 0.27). The only factor predicting transplant-free survival was type 1 HRS. No patients with type 2 HRS survived without transplantation (P = 0.02). CONCLUSIONS: The only factor predicting transplant-free survival following terlipressin therapy is the presence of type 1 HRS. Therefore, it is difficult to justify the use of this drug in patients with type 2 HRS who are not liver transplant candidates.
BACKGROUND: Studies suggest that terlipressin is effective in the treatment of hepatorenal syndrome (HRS). However, factors predicting response to therapy and the long-term outcome of patients have not been defined. METHODS: We reviewed all patients from our institution treated with terlipressin between July 1, 2001 and December 31, 2005 for HRS. Follow up continued until June 30, 2006. HRS was defined according to the International Ascites Club. The following data were retrieved: age, gender, etiology of liver disease, Child-Pugh score, HRS precipitant, therapy duration, creatinine at day 0 and end of treatment, adverse events, and patient outcome. RESULTS: Sixty-nine patients were included. Forty-nine episodes (71%) of HRS were type 1, and 20 episodes (29%) type 2. Forty-one (59.4%) patients responded to terlipressin. Two variables predicted renal function improvement: type 1 HRS and age. Twenty-one (30.4%) patients survived; 17 (81%) had type 1 HRS while four (19%) had type 2 HRS (P = 0.27). The only factor predicting transplant-free survival was type 1 HRS. No patients with type 2 HRS survived without transplantation (P = 0.02). CONCLUSIONS: The only factor predicting transplant-free survival following terlipressin therapy is the presence of type 1 HRS. Therefore, it is difficult to justify the use of this drug in patients with type 2 HRS who are not liver transplant candidates.
Authors: Marc Nguyen-Tat; Julia Jäger; Johannes Wilhelm Rey; Michael Nagel; Christian Labenz; Marcus-Alexander Wörns; Peter Robert Galle; Jens Uwe Marquardt Journal: United European Gastroenterol J Date: 2019-02-20 Impact factor: 4.623
Authors: Ki Tae Suk; Soon Koo Baik; Jung Hwan Yoon; Jae Youn Cheong; Yong Han Paik; Chang Hyeong Lee; Young Seok Kim; Jin Woo Lee; Dong Joon Kim; Sung Won Cho; Seong Gyu Hwang; Joo Hyun Sohn; Moon Young Kim; Young Bae Kim; Jae Geun Kim; Yong Kyun Cho; Moon Seok Choi; Hyung Joon Kim; Hyun Woong Lee; Seung Up Kim; Ja Kyung Kim; Jin Young Choi; Dae Won Jun; Won Young Tak; Byung Seok Lee; Byoung Kuk Jang; Woo Jin Chung; Hong Soo Kim; Jae Young Jang; Soung Won Jeong; Sang Gyune Kim; Oh Sang Kwon; Young Kul Jung; Won Hyeok Choe; June Sung Lee; In Hee Kim; Jae Jun Shim; Gab Jin Cheon; Si Hyun Bae; Yeon Seok Seo; Dae Hee Choi; Se Jin Jang Journal: Korean J Hepatol Date: 2012-03-22
Authors: Mitra K Nadim; John A Kellum; Andrew Davenport; Florence Wong; Connie Davis; Neesh Pannu; Ashita Tolwani; Rinaldo Bellomo; Yuri S Genyk Journal: Crit Care Date: 2012-02-09 Impact factor: 9.097