Hepatorenal syndrome and liver transplantation

Thomas A. Gonwa

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Patients with end- stage liver disease often present with hepatorenal syndrome (HRS). Prior to the introduction of liver transplant this was a fatal complication. However, these patients can now undergo successful liver transplantation. HRS, however, leads to increased mortality on the waiting list, difficult intraoperative and postoperative challenges and decreased survival compared to non- HRS patients. These include renal replacement support, fluid and electrolyte shifts, and postoperative immunosuppression. HRS patients have longer ICU stays, hospital length of stay, decreased long- term renal function and a higher incidence of end- stage renal disease following liver transplantation. Despite this, the 5- year survival can exceed 65%. There has been a recent trend in increasing liver kidney transplantation. Efforts are underway to develop criteria for patients who would benefit from combined liver kidney transplantation, and these are reviewed. Recent research has indicated that reversing HRS preoperatively may improve long- term survival postoperatively and this area of research needs to be expanded.

Original languageEnglish (US)
Title of host publicationAscites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment
PublisherS. Karger AG
Pages198-207
Number of pages10
Volume28
ISBN (Print)9783805595926, 9783805595919
DOIs
StatePublished - Dec 21 2010

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Hepatorenal Syndrome
Liver Transplantation
Kidney Transplantation
Survival
Length of Stay
Fluid Shifts
Kidney
End Stage Liver Disease
Waiting Lists
Research
Immunosuppression
Electrolytes
Chronic Kidney Failure
Transplants
Mortality
Liver
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Gonwa, T. A. (2010). Hepatorenal syndrome and liver transplantation. In Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment (Vol. 28, pp. 198-207). S. Karger AG. https://doi.org/10.1159/000318995

Hepatorenal syndrome and liver transplantation. / Gonwa, Thomas A.

Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. Vol. 28 S. Karger AG, 2010. p. 198-207.

Research output: Chapter in Book/Report/Conference proceedingChapter

Gonwa, TA 2010, Hepatorenal syndrome and liver transplantation. in Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. vol. 28, S. Karger AG, pp. 198-207. https://doi.org/10.1159/000318995
Gonwa TA. Hepatorenal syndrome and liver transplantation. In Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. Vol. 28. S. Karger AG. 2010. p. 198-207 https://doi.org/10.1159/000318995
Gonwa, Thomas A. / Hepatorenal syndrome and liver transplantation. Ascites, Hyponatremia and Hepatorenal Syndrome: Progress in Treatment. Vol. 28 S. Karger AG, 2010. pp. 198-207
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