الفهرس 
Review of Literature
Liver cirrhosisOnly 14 pages are availabe for public view
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Abstract
Hepatorenal syndrome is the dreaded complication of end-stage liver disease characterized by functional renal failure due to renal vasoconstriction in the absence of underlying kidney pathology The pathogenesis of hepatorenal syndrome is the result of an extreme underfilling of the arterial circulation secondary to an arterial vasodilatation located in the splanchnic circulation. This triggers a compensatory response with activation of vasoconstrictor systems leading to intense renal vasoconstriction. Liver transplantation is the best option in suitable candidates, but it is not always applicable due to the short survival expectancy and donor shortage. Pharmacological therapies based on the use of vasoconstrictor drugs (terlipressin, midodrine, or octreotide) are the most promising in the aim of successfully offering a bridge to liver transplantation. Other treatments such as TIPS and albumin dialysis are effective but experience is very limited Yet there still are unanswered questions, mainly related to the best modality of therapy and the predictability of the need for LKT versus a liver-only transplant. Until now The recovery rate of renal function after liver transplantation still is variable between centers, reflecting difficulties in HRS diagnosis and probably underutilization of kidney biopsies. Studies to compare the impact of various pretransplantation therapeutic modalities on outcomes after liver transplantation are deeply needed and still are awaited.