Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1987 Apr;205(4):415–419. doi: 10.1097/00000658-198704000-00012

The reversal of the hepatorenal syndrome in four pediatric patients following successful orthotopic liver transplantation.

R P Wood, D Ellis, T E Starzl
PMCID: PMC1492729  PMID: 3551858

Abstract

Four pediatric patients are presented in whom profound renal failure (hepatorenal syndrome) developed in association with severe end-stage liver disease. All four patients had successful orthotopic liver transplantation. Special emphasis is given to the preoperative and postoperative renal function in the patients, and the criteria used to establish the diagnosis of the hepatorenal syndrome are discussed. In the initial work on liver transplantation and reversal of the hepatorenal syndrome, two of the three patients recovered renal function but died in the perioperative period. The four patients presented in this report have not only had reversal of the hepatorenal syndrome after successful orthotopic liver transplantation but have also survived long term. The four patients have been followed up for periods ranging from 18 months to 4.5 years. Three of the four patients have maintained near normal renal function, whereas the fourth patient (who had a left nephrectomy for obstruction and sepsis) has had a significant decline in renal function.

Full text

PDF
415

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adler A. J., Feldman J., Friedman E. A., Berlyne G. M. Use of extracorporeal ascites dialysis in combined hepatic and renal failure. Nephron. 1982;30(1):31–35. doi: 10.1159/000182428. [DOI] [PubMed] [Google Scholar]
  2. Conn H. O. A rational approach to the hepatorenal syndrome. Gastroenterology. 1973 Aug;65(2):321–340. [PubMed] [Google Scholar]
  3. Espinel C. H. The FENa test. Use in the differential diagnosis of acute renal failure. JAMA. 1976 Aug 9;236(6):579–581. doi: 10.1001/jama.236.6.579. [DOI] [PubMed] [Google Scholar]
  4. Iwatsuki S., Popovtzer M. M., Corman J. L., Ishikawa M., Putnam C. W., Katz F. H., Starzl T. E. Recovery from "hepatorenal syndrome" after orthotopic liver transplantation. N Engl J Med. 1973 Nov 29;289(22):1155–1159. doi: 10.1056/NEJM197311292892201. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Krumlovsky F. A., del Greco F., Niederman M. Prolonged hemoperfusion and hemodialysis in management of hepatic failure and hepatorenal syndrome. Trans Am Soc Artif Intern Organs. 1978;24:235–238. [PubMed] [Google Scholar]
  6. Metz R. J., Tompkins R. K. The hepatorenal syndrome. Surg Gynecol Obstet. 1976 Aug;143(2):297–304. [PubMed] [Google Scholar]
  7. Parsons V., Wilkinson S. P., Weston M. J. Use of dialysis in the treatment of renal failure in liver disease. Postgrad Med J. 1975 Aug;51(598):515–520. doi: 10.1136/pgmj.51.598.515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Schwartz M. L., Vogel S. B. Treatment of hepatorenal syndrome. Am J Surg. 1980 Mar;139(3):370–373. doi: 10.1016/0002-9610(80)90295-0. [DOI] [PubMed] [Google Scholar]
  9. Steiner R. W. Interpreting the fractional excretion of sodium. Am J Med. 1984 Oct;77(4):699–702. doi: 10.1016/0002-9343(84)90368-1. [DOI] [PubMed] [Google Scholar]
  10. Wilkinson S. P., Weston M. J., Parsons V., Williams R. Dialysis in the treatment of renal failure in patients with liver disease. Clin Nephrol. 1977 Jul;8(1):287–292. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES