Therapy <strong>of</strong> <strong>hepatorenal</strong> Syndrom <strong>with</strong> Terlipressin - 12 - function after 34, 36 and 111 days. The 9 other patients died during follow-up (4 from sepsis, 2 from digestive bleeding and 3 from liver failure). No ischaemic complications were encountered during the treatment. CONCLUSIONS: Long-term terlipressin administration is safe and effective to control type 1 HRS. However, it does not cure the un<strong>de</strong>rlying disease and therefore, may only be consi<strong>de</strong>red as a bridge to a <strong>de</strong>finitive treatment as liver transplantation. [#19] Hepatorenal Syndrome. Planas R, Bataller R, Ro<strong>de</strong>s J. Liver Section, Gastroenterology Department, Hospital Universitari Germans Trias i Pujol, Carretera <strong>de</strong>l Canyet, 08916 Badalona, Spain. Curr Treat Options Gastroenterol 2000 Dec;3(6):445-450 The management <strong>of</strong> the <strong>hepatorenal</strong> <strong>syndrome</strong> (HRS) constitutes a major challenge for clinicians. Because HRS is a functional disor<strong>de</strong>r due to advanced liver disease and is associated <strong>with</strong> a very low survival expectancy, orthotopic liver transplantation (OLT) is the only effective and permanent treatment for patients <strong>with</strong> HRS. However, OLT is not applicable to all cirrhotic patients <strong>de</strong>spite the presence <strong>of</strong> HRS. In addition, because <strong>of</strong> the poor prognosis <strong>of</strong> HRS and the prolonged waiting lists in most transplant centers a significant proportion <strong>of</strong> these patients may die before OLT is possible. Therefore, there is a need for effective therapies for HRS that improve renal function and increase survival. Such treatments are <strong>of</strong> interest not only as a bridge to OLT but also as a therapy for patients who are not candidates for transplantation. Preliminary studies have suggested that the administration <strong>of</strong> splanchnic vasoconstrictors such as terlipressin in combination <strong>with</strong> volume expan<strong>de</strong>rs or the insertion <strong>of</strong> transjugular intrahepatic portosystemic shunts (TIPS) may improve renal function in patients <strong>with</strong> HRS. However, before these treatments are wi<strong>de</strong>ly recommen<strong>de</strong>d further studies are necessary. PMID: 11096604 [PubMed - as supplied by publisher] [#20] Terlipressin plus albumin infusion: an effective and safe therapy <strong>of</strong> <strong>hepatorenal</strong> <strong>syndrome</strong>. Uriz J, Gines P, Car<strong>de</strong>nas A, Sort P, Jimenez W, Salmeron JM, Bataller R, Mas A, Navasa M, Arroyo V, Ro<strong>de</strong>s J Institut <strong>de</strong> Malalties Digestives, Hospital Clinic, University <strong>of</strong> Barcelona, Institut d'Investigacions Biomediques August Pi-Sunyer, Catalunya, Spain. J Hepatol 33 (1): 43-48, 2000 (Jul) BACKGROUND/AIM: Ornipressin, a vasopressin analog <strong>with</strong> potent splanchnic vasoconstrictor action, has been shown to reverse <strong>hepatorenal</strong> <strong>syndrome</strong>. However, its usefulness in clinical practice is limited by frequent ischemic complications. The aim <strong>of</strong> this study was to assess the efficacy <strong>of</strong> terlipressin, an analog <strong>of</strong> vasopressin <strong>with</strong> a low pr<strong>of</strong>ile <strong>of</strong> si<strong>de</strong> effects, plus albumin in this condition.
Prepared by K.-D. Döhler - 13 - METHODS: Nine consecutive patients <strong>with</strong> cirrhosis and <strong>hepatorenal</strong> <strong>syndrome</strong> were inclu<strong>de</strong>d in a pilot study <strong>of</strong> terlipressin (0.5-2 mg/4 h i.v.) therapy associated <strong>with</strong> iv albumin. RESULTS: <strong>Treatment</strong> (9 days, range 5-15) was associated <strong>with</strong> a marked reduction <strong>of</strong> serum creatinine (3.9+/-0.7 to 1.3+/-0.1 mg/dl, p
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