Background: Pretransplant renal function is the major determinant of survival after liver transplantation (LTx). Patients with hepatorenal syndrome (HRS) have a poor outcome after LTx compared with patients transplanted without HRS.
Aim: To analyze the impact of treatment of HRS before LTx on outcome after transplantation.
Methods: The outcome of patients with HRS (n=9) treated with vasopressin analogues before LTx was compared with that of a contemporary control group of patients without HRS (n=27) matched by age, severity of liver failure, and type of immunosuppression.
Results: Cases and controls were similar with respect to pretransplantation characteristics. Three-year survival probability was similar between the two groups (HRS-treated: 100% vs control: 83%, P=0.15). No significant differences were found between the two groups with respect to the incidence of impairment of renal function after LTx (HRS-treated: 22% vs control: 30%), severe infections (22 vs 33%), acute rejection (33 vs 41%), days in Intensive Care Unit (6+/-1 vs 8+/-1), days in hospital (27+/-4 vs 31+/-4), and transfusion requirements (11+/-3 vs 10+/-2 units).
Conclusions: Patients with HRS treated with vasopressin analogues before LTx have a posttransplantation outcome similar to that of patients transplanted with normal renal function. These results suggest that HRS should be treated before LTx.