title: Hepatorenal syndrome: do the vasoconstrictors work?
abstract: The development of hepatorenal syndrome (HRS) is related to many changes associated with advanced cirrhosis. Because vasoconstrictors correct systemic and splanchnic hemodynamic abnormalities, they are effective treatments for HRS, although only in approximately 40% of HRS patients. Emerging data show that combination treatment with vasoconstrictors and TIPS may yield better outcomes than either alone. All HRS patients should be assessed for liver transplantation. Reversing HRS before transplantation is associated with better long-term survival. Combined liver– kidney transplantation is indicated for those with irreversible kidney injury. Otherwise, there is some merit in performing a liver transplant first and only considering a kidney transplant later.
authors: Division of Gastroenterology, Department of Medicine, 9N/983, Toronto General Hospital, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G2C4, Canada.
authors: Wesley
authors: W
authors: Leung
authors: Florence
authors: F
authors: Wong
mesh_terms: D003131:Combined Modality Therapy; D006530:Hepatorenal Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016031:Liver Transplantation; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011379:Prognosis; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D014662:Vasoconstrictor Agents