Management of refractory ascites and hepatorenal syndrome

[Guest guest]

Journal of Gastroenterology and Hepatology

Volume 17 Issue 4 Page 456 - April 2002

ADVANCES IN LIVER DISEASE: ALCOHOLIC HEPATITIS, NON-CIRRHOTIC PORTAL

FIBROSIS AND COMPLICATIONS OF CIRRHOSIS

Management of refractory ascites and hepatorenal syndrome

Anuchit Chutaputti

AbstractRefractory 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.

© 2002 Blackwell Publishing Asia Pty Ltd

------------------------------

[Guest guest]

Journal of Gastroenterology and Hepatology

Volume 17 Issue 4 Page 456 - April 2002

ADVANCES IN LIVER DISEASE: ALCOHOLIC HEPATITIS, NON-CIRRHOTIC PORTAL

FIBROSIS AND COMPLICATIONS OF CIRRHOSIS

Management of refractory ascites and hepatorenal syndrome

Anuchit Chutaputti

AbstractRefractory 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.

© 2002 Blackwell Publishing Asia Pty Ltd

------------------------------

[Guest guest]

Journal of Gastroenterology and Hepatology

Volume 17 Issue 4 Page 456 - April 2002

ADVANCES IN LIVER DISEASE: ALCOHOLIC HEPATITIS, NON-CIRRHOTIC PORTAL

FIBROSIS AND COMPLICATIONS OF CIRRHOSIS

Management of refractory ascites and hepatorenal syndrome

Anuchit Chutaputti

AbstractRefractory 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.

© 2002 Blackwell Publishing Asia Pty Ltd

------------------------------

[Guest guest]

Journal of Gastroenterology and Hepatology

Volume 17 Issue 4 Page 456 - April 2002

ADVANCES IN LIVER DISEASE: ALCOHOLIC HEPATITIS, NON-CIRRHOTIC PORTAL

FIBROSIS AND COMPLICATIONS OF CIRRHOSIS

Management of refractory ascites and hepatorenal syndrome

Anuchit Chutaputti

AbstractRefractory 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.

© 2002 Blackwell Publishing Asia Pty Ltd

------------------------------