Patients with preoperative hepatorenal syndrome (HRS) have comparable long-term outcomes after live-donor liver transplantation (LDLT)

Abstract

BACKGROUND: The aim of this retrospective review was to determine whether preoperative hepatorenal syndrome (HRS) was associated with poor postoperative outcomes after live donor liver transplantation (LDLT). METHODS: A total of 307 adult patients (age≥ 18) who had LDLT done from July 1994 to December 2007 were included in the analysis. The median follow-up period was 55 months. RESULTS: 285 patients received right lobe liver grafts with middle hepatic vein, 2 of the right lobe grafts were without middle hepatic vein. The remaining 20 patients received left lobe liver grafts. 47 patients (15.3%) had preoperative hepatorenal syndrome. There was significantly more patients with pre-operative HRS developed post-operative complications (p=0.006), in which, development of intra-abdominal collection (p=0.001), chest infection (p=0.02) and wound infection (p=0.05) had significantly higher rate when compared to patients without HRS. There was significantly more patients with preoperative HRS died during the hospital stay (p=0.001). Also, median day of stay in Intensive Care Unit (ICU) was significantly longer in patients with HRS (10 days vs. 4 days, p=<0.001).The renal function test was comparable in patients with or without pre-operative HRS at post-operative one year (p=0.079). The overall survival after excluding the hospital mortality did not have statistical significant difference (log-rank test, p= 0.84). CONCLUSION: Patients with HRS had more early postoperative complications and hospital mortality. However, the long term survival outcomes and renal function were not affected by the presence of HRS.