Prolonged Terlipressin Therapy as a Bridge to Curative TIPS for HRS-AKI in a Nontransplant Candidate

Hepatorenal syndrome-acute kidney injury (HRS-AKI) is a severe complication of advanced cirrhosis with high mortality and limited treatment options. Terlipressin is currently the only FDA-approved therapy for HRS, though recurrence is common upon discontinuation in patients without access to liver transplantation. Transjugular intrahepatic portosystemic shunt (TIPS) may provide definitive treatment for HRS-AKI in nontransplant candidates or in the setting of prolonged waitlists. This case illustrates the safety and success of terlipressin prior to TIPS for definitive treatment of HRS-AKI in a nontransplant candidate.