Treatment with terlipressin as a bridge to liver transplantation in a patient with hepatorenal syndrome.
Hepatorenal syndrome is a rapidly lethal complication of cirrhosis. The present case provides further evidence of the efficacy of terlipressin in this context even with concomitant treatment with propranolol. A 56 year old male with HBV related cirrhosis developed renal failure characteristic of hepatorenal syndrome. He was also taking propranolol for primary prophylaxis of variceal bleeding. Terlipressin 6 mg/day was administered during haemodialysis and after 1 week plasma creatinine dropped from 6.2 to 2.8 mg%. Daily urinary volume, plasma sodium and natriuresis dramatically increased during the treatment. Discontinuation of the treatment led to a rapid relapse of renal failure (plasma creatinine from 1.8 to 2.2 mg%) and the drug was readministered until a successful liver transplantation could be performed 1 month after the beginning of the treatment. The patient has now a near normal renal function 3 months after transplantation.
Le Moine
O
O
Department of Gastroenterology, Hopital Erasme, Université Libre de Bruxelles, Belgium.
el Nawar
A
A
Jagodzinski
R
R
Bourgeois
N
N
Adler
M
M
Gelin
M
M
Cremer
M
M
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006530:Hepatorenal Syndrome / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D000077585:Terlipressin
D000959:Antihypertensive Agents; D008236:Lypressin; D000077585:Terlipressin; D011433:Propranolol