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Effects of Orthotopic Liver Transplantation on Vasoactive Systems and Renal Function in Patients with Advanced Liver Cirrhosis

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Abstract

The effects of Orthotopic liver transplantation (OLT) on renal function and major vasoactive factors was assessed in end-stage cirrhotic patients. Renal function, mean arterial pressure, and plasma vasoactive hormones were measured In 22 cirrhotic patients with refractory ascites before and after OLT. Before OLT, mean arterial pressure, glomerular filtration rate, free water clearance, and fractional sodium excretion serum sodium levels were decreased. In addition, serum creatinine and plasma levels of vasoactive factors were increased. Ten of these patients fulfilled criteria of hepatorenal syndrome (HRS). Nine to 12 months after transplantation, renal function had improved and plasma levels of vasoactive factors had decreased significantly in all patients, including those with HRS. However, glomerular filtration rate remained subnormal and plasma endothelin-1 levels and plasma renin activity remained increased in most of them. In conclusion, OLT improves renal function in patients with end-stage liver cirrhosis, including those with HRS. However, renal function remains subnormal in most of these patients.

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Authors and Affiliations

  1. Department of Gastroenterology, Hospital Universitario “12 de Octubre.”, 28041-, Madrid

    Concepción Cassinello, Beatriz Cuenca & José Antonio Solís-Herruzo

  2. Hospital Universitario “Miguel Servet”, 5012-, Zaragoza, Spain

    Concepción Cassinello, Enrique Moreno, Adolfo Gozalo, Blanca Ortuño, Beatriz Cuenca & José Antonio Solís-Herruzo

  3. Department of Surgery, Hospital Universitario “12 de Octubre.”, 28041-, Madrid

    Enrique Moreno

  4. Department of Biochemistry, Hospital Universitario “12 de Octubre.”, 28041-, Madrid

    Adolfo Gozalo

  5. Department of Nuclear Medicine, Hospital Universitario “12 de Octubre.”, 28041-, Madrid

    Blanca Ortuño

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  1. Concepción Cassinello
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Cassinello, C., Moreno, E., Gozalo, A. et al. Effects of Orthotopic Liver Transplantation on Vasoactive Systems and Renal Function in Patients with Advanced Liver Cirrhosis. Dig Dis Sci 48, 179–186 (2003). https://doi.org/10.1023/A:1021763221337

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