Outcomes of liver transplantation in patients with hepatorenal syndrome

Table 1 The role of terlipressin and albumin in hepatorenal syndrome-1

Ref.	Terlipressin dose	Albumin	Length	Terlipressin group: Cr (mg/dL) or Cr Cl (mL/min)	Control group: Cr (mg/dL) or Cr Cl (mL/min)	30 d survival (terlipressin vs control)	Transplant free outcome
Hadengue et al[113]	1 mg twice daily	No	2 d	Cr Cl: 27 ± 4	Cr Cl: 15 ± 2	N/A	N/A
Halimi et al[49]	4 mg/d	Yes	7 d (mean)	Decline in Cr from 31%-75% from day 0 to day 5	N/A	13/18 (72%) patient response	N/A
Danalioglu et al[42]	2-4 mg/d	Yes	6 d	N/A	N/A	20% vs 0%	N/A
Testro et al[54]	1 mg every 6 h (max of 8 mg/d)	Yes	12 d	N/A	N/A	17/49 HRS type 1, 4/20 HRS type 2	All transplant free outcomes responded to terlipressin
Sanyal et al[46]	1 mg every 6 h (doubled on 4 d if Cr did not < 30%)	No (control group received albumin)	14 d	Cr < 1.5 mg/dL (19/59, 33.9%)	Cr < 1.5 mg/dL (7/56, 12.5%)	N/A	42.9% (24/56) vs 37.5% (21/56) in terlipressin vs control group at 180 d
von Kalckreuth et al[47]	3.9 mg ± 1.3 mg (responders) vs 3.4 mg ± 1.4 mg (nonresponders)	Yes	6 ± 4.9 d (responder) vs 8 ± 6.3 d (non-responders)	N/A	N/A	Complete response by day 7 was 52%, while at day 17 it was 84%	25/38 (66%) of treatment complete response was achieved
Boyer et al[44]	1 mg every 6 h	Yes	6.3 d (mean)	Cr: 2.8 mg/dL	Cr: 3.8 mg/dL	N/A	34% non-transplanted survival 100% transplant survival at 180 d
Hinz et al[51]	2-6 mg/d	Yes	N/A	N/A	N/A	57% of patients (12/21) responded to terlipressin. Age was a negative predictor for treatment response	No difference seen in mortality between responders and non-responders at 60 d
Heidemann et al[50]	26.43 ± 30.86 (total dose for responders) vs 32.11 ± 31.57 (total dose for non-responders)	Yes	9 d (responders) vs 10.5 d (non-responders)	N/A	N/A	One month survival was longer in responders vs non-responders (P = 0.048)	N/A
Sagi et al[45] (meta-analysis)	N/A	Yes	Minimum of 3 d of terlipressin	Cr must have been < 1.5 mg/dL at treatment end	N/A	Four trials (n = 223) with RR for reversal in type 1 HRS with terlipressin was 3.66 (95%CI: 2.15-6.23)	N/A
Fabrizi et al[48] (meta-analysis)	N/A	N/A	N/A	N/A	N/A	Five trials (n = 243 patients) with pooled OR of HRS reversal was 8.09 (95%CI: 3.52; 18.59)	Recovery of renal function occurs in less than 50% of patients with HRS even with terlipressin

Cr: Creatinine; Cr Cl: Creatinine clearance; HRS: Hepatorenal syndrome; N/A: Not available.