Premium
Clinical outcomes of patients with hepatorenal syndrome after living donor liver transplantation
Author(s) -
Lee Jung Pyo,
Kwon Hyuk Yong,
Park Ji In,
Yi NamJoon,
Suh KyungSuk,
Lee Hae Won,
Kim Myounghee,
Oh Yun Kyu,
Lim Chun Soo,
Kim Yon Su
Publication year - 2012
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.23493
Subject(s) - medicine , hepatorenal syndrome , hazard ratio , liver transplantation , surgery , liver disease , gastroenterology , cohort , survival rate , renal replacement therapy , transplantation , renal function , confidence interval , cirrhosis
Abstract Liver transplantation (LT) is the treatment of choice for hepatorenal syndrome (HRS). However, the clinical benefits of living donor liver transplantation (LDLT) are not yet well established. We, therefore, investigated the outcomes of patients with HRS who underwent LDLT and patients with HRS who received transplants from deceased donors. This study focused on 71 patients with HRS out of a total of 726 consecutive adult Korean patients who underwent LT at a single Asian center. We compared 48 patients who underwent LDLT with 23 patients who underwent deceased donor liver transplantation (DDLT). Patients with HRS showed poorer survival than patients without HRS ( P = 0.01). Poorer survival was associated with higher in‐hospital mortality for patients with HRS (18.3% versus 5.2%, P < 0.001). In comparison with DDLT, LDLT was associated with younger donors and shorter ischemic times. The survival rate with LDLT was significantly higher than the survival rate with DDLT ( P = 0.02). Among patients with high Model for End‐Stage Liver Disease scores (≥30) or type 1 HRS, the survival rates for the LDLT group were not inferior to those for the DDLT group. LDLT significantly improved recipient survival after adjustments for several risk factors (hazard ratio = 0.20, 95% confidence interval = 0.05‐0.85, P = 0.03). Kidney function was significantly improved after LT, and there was no difference between LDLT and DDLT. No patients in the HRS cohort required maintenance renal replacement therapy. In conclusion, LDLT may be a beneficial option for patients with HRS. Liver Transpl 18:1237–1244, 2012. © 2012 AASLD.