Hepatorenal Syndrome (HRS) is a serious complication that can occur in patients with liver cirrhosis, characterised by kidney dysfunction, or acute kidney failure (AKI). While it has traditionally been thought that HRS affects structurally normal kidneys and is completely reversible with liver transplantation, recent evidence suggests this may not always be the case. The purpose of this study is to examine the actual structural changes in the kidneys of patients with HRS through tissue biopsy and advanced molecular analysis. This may help us better understand the disease mechanism and potentially improve treatment approaches. We aim to challenge the current understanding that HRS always occurs in structurally normal kidneys and is always reversible after liver transplantation. This study will provide valuable insights into the pathophysiology of HRS and may lead to improved diagnostic and treatment strategies in the future. This is a 3-year single center prospective, non-randomised, open label study at Queen Mary Hospital, The University of Hong Kong. All consecutive patients accepted on the liver transplant waiting list will be invited to participate. Patient will undergo several procedures related to liver transplant and kidney assessment, and receive liver transplantation and renal biopsy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
42
To examine the actual structural changes in kidneys of patients with HRS through tissue biopsy and advanced molecular analysis, and hope that may help us better understand the disease mechanism and potentially improve treatment approaches
Queen Mary Hospital
Hong Kong, Hong Kong
Proportion of patients with HRS AKI
Proportion of patients with HRS AKI who have normal, reversible or permanent injury on renal histopathology
Time frame: up to 3 years
Histopathological changes
Histopathological changes and their association with clinical parameters
Time frame: up to 3 years
Duration of HRS AKI
Incidence and duration of HRS AKI
Time frame: up to 3 years
Response to standard treatment (Terlipressin and albumin)
Response to standard treatment (Terlipressin and albumin)
Time frame: up to 3 years
Perioperative morbidity
Perioperative morbidity including need and duration for renal replacement therapy
Time frame: up to 3 years
Post-transplant renal recovery rates
Post-transplant renal recovery rates
Time frame: up to 3 years
Transcriptomic signature differences
Transcriptomic signature differences between HRS AKI and non-HRS AKI patients
Time frame: up to 3 years
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