TREATMENT WITH TERLIPRESSIN AS A BRIDGE TO LIVER-TRANSPLANTATION IN APATIENT WITH HEPATORENAL-SYNDROME

Hepatorenal syndrome is a rapidly lethal complication of cirrhosis. Th e present case provides further evidence of the efficacy of terlipress in in this context even with concomitant treatment with propranolol. A 56 year old male with HBV related cirrhosis developed renal failure c haracteristic of hepatorenal syndrome. He was also taking propranolol for primary prophylaxis of variceal bleeding. Terlipressin 6 mg/day wa s administered during haemodialysis and after 1 week plasma creatinine dropped from 6,2 to 2,5 mg%. Daily urinary volume, plasma sodium and natriuresis dramatically increased during the treatment. Discontinuati on of the treatment led to a rapid relapse of renal failure (plasma cr eatinine from 1,8 to 2,2 mg%) and the drug was readministered until a successful liver transplantation could be performed I month after the beginning of the treatment. The patient has now a near normal renal fu nction 3 months after transplantation.