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 21 November 2017

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News

Model of end-stage liver disease for hepatorenal syndrome prognosis

Outcomes for patients with cirrhosis and hepatorenal syndrome can be estimated by hepatorenal syndrome type and model of end-stage liver disease score, variables particularly useful for liver transplant candidates, reports the latest Hepatology issue.

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Important progress has been made recently regarding the pathogenesis and treatment of hepatorenal syndrome.

However, scant information exists about factors predicting outcome in patients with cirrhosis and hepatorenal syndrome.

Moreover, the prognostic value of the model of end-stage liver disease score has not been validated in the setting of hepatorenal syndrome.

The model of end-stage liver disease score in type 2 hepatorenal syndrome was 20 with 3 months median survival
Hepatology

Dr Mónica Guevara and colleagues from Spain designed a study to assess the prognostic factors and outcome of patients with cirrhosis and hepatorenal syndrome.

The research team included 105 consecutive patients with hepatorenal syndrome.

The team reported that 41 patients had type 1 hepatorenal syndrome, while 64 patients had type 2 hepatorenal syndrome.

The researchers noted that patients with type 1 hepatorenal syndrome had more severe liver and renal failure than type 2 patients.

Patients with type 1 hepatorenal syndrome also had greater impairment of circulatory function, as indicated by lower arterial pressure and higher activation of vasoconstrictor factors.

The investigators observed that in the whole series, the median survival was 3 months.

The investigative team conducted a multivariate analysis of survival, and found that only hepatorenal syndrome type and model of end-stage liver disease score were associated with an independent prognostic value.

The researchers noted that all patients with type 1 hepatorenal syndrome had a high model of end-stage liver disease score of 20 and showed an extremely poor outcome with a median survival of 1 month.

By contrast, the team found that survival of patients with type 2 hepatorenal syndrome was longer and dependent on model of end-stage liver disease score.

Patients with type 2 hepatorenal syndrome with a model of end-stage liver disease score of 20 had a median survival of 3 months and a score less than 20 showed a median survival of 11 months.

Dr Guevara concluded, “The outcome of patients with cirrhosis and hepatorenal syndrome can be estimated by using two easily available variables, hepatorenal syndrome type and model of end-stage liver disease score.”

“These data can be useful in the management of patients with hepatorenal syndrome, particularly for patients who are candidates for liver transplantation.”

Hepatol 2005: 41(6): 1282-9
25 May 2005

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