Transplantation of Cadaveric Kidneys from Patients with Hepatorenal Syndrome

Abstract

A kidney from each of five patients and both kidneys from a sixth patient dying with the hepatorenal syndrome (severe hepatic failure, oliguria, azotemia, hyponatremia and a urinary sodium of less than 5 mEq per day) were transplanted into seven patients with end-stage kidney disease whose liver function was normal. Diuresis and improvement of renal function occurred in all but one recipient. Because of postoperative complications, two kidneys were removed after diuresis had occurred. Four transplanted kidneys achieved stable function for six months or longer, with creatinine clearances of 25, 42, 50 and 52 ml per minute. The hepatorenal syndrome is functional and potentially reversible.