Abstract:

BACKGROUND: Renal impairment of varying degree is common at perioperative period of liver transplantation and especially has immediate impact on survival of hepatorenal syndrome (HRS) patients.
OBJECTIVE: To investigate the role of perioperative comprehensive renoprotective treatment in improving the renal function and survival rate of HRS patients after liver transplantation.
METHODS: All 54 patients with preoperative HRS were divided into two groups: The latter 34 patients received comprehensive renoprotective treatment (renoprotective group) and the former 20 patients did not (non-renoprotective group). Meanwhile, the serum level of creatinine (Cr) was measured and the incidence of postoperative acute renal failure, infection, morbidity, mortality and the ICU stay were determined and compared with the other 117 patients without preoperative HRS (control group).
RESULTS AND CONCLUSION: The serum level of Cr-max was significantly lower and dropped faster in the renoprotective group as comparing with non-renoprotective group, the incidence of postoperative acute renal failure improved in the same way (χ²=6.523, P=0.011). The incidence of infection and perioperative mortality of renoprotective group were the same as that of control group (P > 0.05). Compared with the non-renoprotective group, the patients received comprehensive renoprotective treatment had significantly lower mortality (χ²=6.018, P=0.014), ICU stay and infection rate (P < 0.01). Perioperative comprehensive renoprotective treatment can effectively improve renal function, lower morbidity and promote survival rate in patients with HRS underwent liver transplantation.