A patient with the hepatorenal syndrome treated with a liver transplant — case description with duties of the nursing staff

Abstract

Liver transplantation (LTx) is the first-line treatment for hepatorenal syndrome (HRS). Patients awaiting LTx with decompensated cirrhosis and renal failure are a group of potential recipients with a high risk of developing serious complications and death in the period of expecting for a transplant. The work presents the case of a patient with cirrhosis and a failing liver due to toxic-induced damage; the patient developed HRS type 1. The patient required urgent LTx. During the waiting period s/he undergone haemodialyses. After LTx, there was a normalization in the hepatic and renal parameters. In the ensuing post-transplantation period, the concentration of creatine went down to 0,6–1,0 mg/dl. During waiting for treatment, the patient suffered chiefly from conditions related to cirrhosis and renal failure: jaundice, abdominal dropsy, edema of lower extremity, emaciation, encephalopathy, coagulation disorder, hemodynamic disorder, and anuria. The activities of medical personnel were subject to the patient’s changing condition and employed therapy that was to keep the patient alive and provide safety until the transplantation.