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Terlipressin and albumin combination treatment in hepatorenal syndrome.

OBJECTIVES
Hepatorenal syndrome (HRS) is a severe complication of cirrhosis, leading to death in nearly all of cases in the absence of liver transplantation. Several treatments have been attempted as a bridge to liver transplantation. Promising results have been shown with terlipressin and albumin treatment. The aim of this retrospective study was to evaluate our patients with HRS and the effects of combined therapy of terlipressin and albumin on survival.


PATIENTS AND METHODS
Twenty two patients (15 with type 1 HRS and 7 with type 2 HRS) who were admitted to our clinic between 1996 and 2001, were enrolled. All 7 pts with type 1 HRS were given terlipressin 2-4 mg/day and albumin 2 x 20 g/day for 6 days (range: 3-14).


RESULTS
Rate of mortality in hospital was 64% in total group, 80% in type 1 and 29% in type 2. Additionally rate of death was 57% in type 1 patients that received terlipressin+albumin and 100% in unreceived ones (p<0.05).


CONCLUSION
In this retrospective study, survival following improvement in renal function was noted in nearly half (43%) of type 1 patients that received terlipressin+albumin. Parameters associated with response to terlipressin+albumin and increased survival should be defined better in a large cohort of cirrhotic patients with HRS.