Management of Hepatorenal Syndrome: A Review.
HRS
Liver transplant for HRS
Management
Journal
Journal of clinical and translational hepatology
ISSN: 2225-0719
Titre abrégé: J Clin Transl Hepatol
Pays: United States
ID NLM: 101649815
Informations de publication
Date de publication:
28 Jun 2020
28 Jun 2020
Historique:
received:
14
02
2020
revised:
23
04
2020
accepted:
08
05
2020
entrez:
25
8
2020
pubmed:
25
8
2020
medline:
25
8
2020
Statut:
ppublish
Résumé
Acute kidney injury (AKI) occurs frequently in patients with cirrhosis, and hepatorenal syndrome (HRS) is second most common etiology of AKI after volume responsible pre-renal etiology. AKI in these patients negatively impacts pre- and post-transplant patient survival and healthcare burden. Reduced effective blood volume with consequent reduced renal blood flow, along with systemic inflammation in patients with decompensated cirrhosis, result in susceptibility to HRS. In this article, we will review updates over the last 5 years on the changing definition with diagnostic criteria and nomenclature of AKI and HRS, data on medical treatment with vasoconstrictors, and urinary biomarkers in diagnosis of etiology of AKI. We will also discuss the significance of liver transplantation evaluation once the diagnosis of HRS is established and the post-transplant immunosuppression management. We will also review one of the challenging issues that remains among transplant-eligible patients, that of allocation of simultaneous liver kidney transplant. Finally, we will review the new implemented policy from the Organ Procurement Transplant Network on simultaneous liver kidney allocation.
Identifiants
pubmed: 32832400
doi: 10.14218/JCTH.2020.00011
pii: JCTH.2020.00011
pmc: PMC7438356
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
192-199Informations de copyright
© 2020 Authors.
Déclaration de conflit d'intérêts
The authors have no conflict of interests related to this publication.
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