Management of refractory ascites and hepatorenal syndrome.

liver411

J Gastroenterol Hepatol 2002 Apr;17(4):456-61

Chutaputti A
Section of Digestive and Liver Diseases, Department of Medicine,
Phramongkutklao Hospital, Bangkok, Thailand. [email protected]

Refractory ascites and hepatorenal syndrome (HRS) are the late complications of the terminal stages of cirrhosis. The definitions of refractory ascites and HRS proposed by the International Ascites Club in 1996 are now widely accepted, and are useful in diagnosis, treatment and research in this field. In both conditions, the only treatment of proven value for improved survival is liver transplantation. However, because of better understanding about the pathophysiology of HRS, including the roles of portal hypertension, ascites formation and hemodynamic derangements, treatments such as transjugular intrahepatic portasystemic shunt (TIPS) and new pharmacological agents may be considered to alleviate the problem prior to transplantation. Symptomatic
treatment of refractory ascites includes TIPS and repeated large volume
paracentesis. Transjugular intrahepatic portasystemic shunt can improve
survival while waiting for liver transplantation. Practical management
guidelines for TIPS and large volume paracentesis, including the prevention
and management of further complications, are considered in this review.
Copyright 2002 Blackwell Publishing Asia Pty Ltd

Publication Types:


a.. Review
b.. Review, tutorial
PMID: 11982727, UI: 21979658