No abstract available.
Hepatorenal Syndrome*

No abstract available.
Hepatorenal Syndrome*

Hepatorenal Syndrome ; etiology ; Humans

Hepatorenal Syndrome ; diagnosis ; therapy ; Humans ; Prognosis

Combined Modality Therapy ; Hepatorenal Syndrome ; Humans

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

PURPOSE: To evaluate the usefulness of renal resistive index(RI) in patients with liver cirrhosis as an indicator for predicting hepatorenal syndrome. MATERIALS AND METHODS: Renal RIs of thirty cirrhotic patients were analyzed using the gray-scale and Doppler ultrasonograms. As a control group, eight normal subjects were alsoincluded. Renal RIs were measured at three sites of interlobar or arcuate arteries of both kidneys. The patients were divided into three groups (A, B, or C) according to the Child-Turcotte-Pugh classification and their serum BUN and creatinine levels were compared. We determined whether RIs of normal controls differed from those of cirrhotic patients or whether RIs of cirrhotic patients correlated with the Child-Turcotte-Pugh classification or BUN and creatinine levels. RESULTS: Mean RIs(0.63 +/-0.03) of normal subjects were statistically different from those(0.67 +/-0.05) of cirrhotic patients(P=0.009). RIs of group A(n=6), B(n=9) and C(n=15) were 0.65 +/-0.03,0.65 +/-0.04 and 0.70 +/-0.04, respectively. The ANOVA test revealed statistically significant differences between the three groups(F ratio=4.472, P=0.021). RIs did not correlate with BUN or creatinine levels. CONCLUSION: RI could be used as an index for predicting hepatorenal syndrome before the renal function becomes impaired.
Arteries ; Classification ; Creatinine ; Hepatorenal Syndrome* ; Humans ; Kidney ; Liver Cirrhosis ; Ultrasonography

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

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

Kidney or liver transplantation is a standard therapeutic procedure if one of these organs fail. However, the need for transplantation of both organs may arise with deterioration of organ function especially in hepatorenal syndrome patients. Hepatorenal failure patients are at increased risk for management intraoperatively, because they have complex problems such as renal failure related to volume overload, hyperkalemia, and uremic syndrome. These days, intraoperative use of hemodialysis or ultrafiltration is feasible and achieves successful result in patients undergoing hepatorenal transplantation. Recently, we experienced one case of hepatorenal transplantation. After setting for operation, renal transplantation was done first, and then liver transplantation was also done successfully without any problems of volume overload, massive transfusion and severe electrolyte disturbance. Total required volume for transfusion was packed red cell 9 units, FFP 4 units and crystalloid solution 8,600 ml. Patient was carried to the ICU after 16 hours operation, followed by the extubation 16 hours later in ICU and sent to the ward after 7 days ICU stay.
Hepatorenal Syndrome ; Humans ; Hyperkalemia ; Kidney ; Kidney Transplantation ; Liver Transplantation ; Renal Dialysis ; Renal Insufficiency ; Ultrafiltration