Immediate recovery of renal function after orthotopic liver transplantation in a patient with hepatorenal syndrome requiring hemodialysis for more than 8 months.
Severe liver dysfunction may lead to impairment of renal function without an underlying renal pathology. This phenomenon is called hepatorenal syndrome (HRS), which is associated with a poor prognosis showing a median survival of less than 2 months if renal replacement therapy is necessary. Liver transplantation is the best therapeutic option to regain renal function, but because of poor survival, these patients often die before transplantation. Herein we report a 37-year-old patient with ethyl-toxic liver cirrhosis who underwent hemodialysis due to HRS type I for more than 8 months. After living donor liver transplantation, diuresis immediately resumed, renal function soon recovered, and intermittent hemodialysis was stopped at 18 days after transplantation. Renal function was stable with a serum creatinine <2 mg/dL during the last 5 years posttransplantation. As far as we know, only a few cases of an anuric patient suffering from HRS have been reported with a survival beyond 8 months and full recovery of renal function after liver transplantation. This underlined that renal replacement therapy in HRS should be considered as a possible bridging method to liver transplantation even for longer periods.
Storm
C
C
Department of Nephrology and Medical intensive care, Charit-Campus Virchow, University Hospital of Humboldt-University Berlin, Berlin, Germany. christian.storm@charite.de
Bernhardt
W M
WM
Schaeffner
E
E
Neuhaus
R
R
Pascher
A
A
Neuhaus
P
P
Hasper
D
D
Frei
U
U
Kahl
A
A
D000328:Adult; D004231:Diuresis; D005500:Follow-Up Studies; D006530:Hepatorenal Syndrome / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007677:Kidney Function Tests; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D006435:Renal Dialysis; D016896:Treatment Outcome