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The patient with refractory ascites.

Alexander L Gerbes1

  • 1Klinikum of the University of Munich-Grosshadern, Department of Medicine II, Marchioninistr. 15, 81377 Munich, Germany. gerbes@med.uni-muenchen.de

Best Practice & Research. Clinical Gastroenterology
|June 5, 2007
PubMed
Summary
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Refractory ascites, a sign of advanced liver disease, poses treatment challenges. Vasopressin analogs like terlipressin and albumin show promise in bridging patients to liver transplantation.

Area of Science:

  • Hepatology
  • Nephrology

Background:

  • Refractory ascites signifies advanced chronic liver disease, presenting significant therapeutic challenges.
  • Spontaneous bacterial peritonitis can trigger refractory ascites, indicating a poor prognosis.
  • Standard treatments include therapeutic paracentesis with albumin and transjugular intrahepatic portosystemic shunt (TIPS).

Purpose of the Study:

  • To explore the efficacy of vasopressin analogs and albumin in managing patients with refractory ascites and deteriorating renal function.
  • To evaluate the potential of these treatments as a bridge to liver transplantation.

Main Methods:

  • Review of existing evidence on vasopressin analogs (terlipressin) and albumin administration.
  • Analysis of patient outcomes, focusing on renal function and transplant eligibility.

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Main Results:

  • Increasing evidence supports the use of terlipressin and albumin for bridging patients to liver transplantation.
  • These therapies can help stabilize patients with deteriorating renal function, a complication of hepatorenal syndrome.

Conclusions:

  • Terlipressin and albumin offer a viable strategy for managing complex cases of refractory ascites.
  • These treatments can improve outcomes for patients awaiting liver transplantation.