Combined Modality Therapy ; Hepatorenal Syndrome ; Humans

Hepatorenal Syndrome ; diagnosis ; therapy ; Humans ; Prognosis

Hepatorenal Syndrome ; drug therapy ; Humans ; Vasoconstrictor Agents ; therapeutic use

Hepatorenal Syndrome ; therapy ; Humans ; Liver Transplantation ; Vasoconstrictor Agents ; therapeutic use

Hepatorenal Syndrome ; diagnosis ; prevention & control ; therapy ; Humans ; Liver Transplantation

Chinese Society of Hepatology of Chinese Medical Association organized relevant experts to update the Guidelines on the management of ascites and complications in cirrhosis in 2017 and renamed it as Guidelines on the management of ascites in cirrhosis. It provides guiding recommendations for the diagnosis and treatment of cirrhotic ascites, spontaneous bacterial peritonitis (SBP) and hepatorenal syndrome (HRS).
Humans ; Ascites/therapy* ; Asian People ; Hepatorenal Syndrome/therapy* ; Liver Cirrhosis/therapy* ; Peritonitis/therapy*

Dopamine ; therapeutic use ; Hepatorenal Syndrome ; blood ; therapy ; Humans ; Liver Transplantation ; Vasoconstrictor Agents ; therapeutic use

Ascites ; etiology ; therapy ; Hepatorenal Syndrome ; etiology ; prevention & control ; Humans ; Hyponatremia ; etiology ; therapy ; Liver Cirrhosis ; complications ; therapy ; Sodium ; blood ; Sodium Chloride ; administration & dosage

Combined Modality Therapy ; Drugs, Chinese Herbal ; therapeutic use ; Hepatorenal Syndrome ; etiology ; therapy ; Humans ; Liver Cirrhosis ; complications ; therapy ; Liver Transplantation ; Portasystemic Shunt, Surgical

Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis related complications has been recognized during recent years. This paper aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver cirrhosis related complications. Hepatobiliary Study Group of Chinese Society of Gastroenterology of Chinese Medical Association and Hepatology Committee of Chinese Research Hospital Association have invited gastroenterologists, hepatologists, infectious disease specialists, surgeons, and clinical pharmacists to formulate the clinical practice guidance based on comprehensive literature review and experts' clinical experiences. Overall, 10 major statements regarding efficacy and safety of terlipressin in liver cirrhosis were proposed. Terlipressin can be beneficial for the management of cirrhotic patients with acute variceal bleeding and hepatorenal syndrome (HRS). However, the evidence regarding the use of terlipressin in cirrhotic patients with ascites, post-paracentesis circulatory dysfunction, and bacterial infections and in those undergoing hepatic resection and liver transplantation remains insufficient. Terlipressin-related adverse events, mainly including gastrointestinal symptoms, electrolyte disturbance, and cardiovascular and respiratory adverse events, should be closely monitored. The current clinical practice guidance supports the use of terlipressin for gastroesophageal variceal bleeding and HRS in liver cirrhosis. High-quality studies are needed to further clarify its potential effects in other liver cirrhosis related complications.
Electrolytes ; Esophageal and Gastric Varices/drug therapy* ; Gastrointestinal Hemorrhage/etiology* ; Hepatorenal Syndrome/etiology* ; Humans ; Liver Cirrhosis/drug therapy* ; Lypressin/adverse effects* ; Terlipressin/adverse effects* ; Vasoconstrictor Agents/adverse effects*