Can refractory ascites be cured?

Various therapeutic measures can be used for refractory ascites, including large-volume paracentesis, transjugular intrahepatic portosystemic shunt, vasoconstrictive drugs, and an automated low-flow ascites pump system. However, ascites generally can be resolved only by liver transplantation.

Is ascites common after liver transplant?

Ascites is one of the most common complications after liver transplantation, which is usually transient and self-limited [2]. Conversely, massive and refractory ascites are seen infrequently (5%–7%) in liver transplant recipients, however, it may cause morbidity and mortality [3].

What does it mean when ascites is refractory?

As per the AASLD and EASL guidelines, refractory ascites is defined as ascites that is unresponsive to the appropriate sodium-restricted diet and high-dose diuretics (160 milligrams of daily furosemide and 400 milligrams of daily spironolactone).

What is the best management option for refractory ascites?

Due to the difficulty in receiving a liver transplantation (LT), the ultimate solution for refractory ascites, most cirrhotic patients have selected the palliative therapy such as repeated serial paracentesis, transjugular intrahepatic portosystemic shunt, or peritoneovenous shunt to improve their QOL.

How long can you live with refractory ascites?

Abstract. Introduction Ascites develops in about 90% with advanced cirrhosis; when refractory to medical therapy, standard of care is repeated large volume paracentesis (LVP) with albumin support. Refractory ascites (RA) confers a median life expectancy of six months without liver transplantation (LT).

How do you prevent refractory ascites?

The administration of diuretics at least 2 days after the procedure decreases the chances of ascites recurrence to 18% compared to 93% if diuretics are not continued. The administration of diuretics also shortens hospital stay and reduces the likelihood of readmission.

Can ascites be cured after liver transplant?

Conclusions: Persistent ascites after liver transplantation is rare, but is associated with reduced 1-year survival. The underlying mechanisms are diverse, abdominal bacterial infection being the most common cause. The majority of cases can be successfully treated.

Does liver transplant cure ascites?

Can ascites be cured? Treatments for ascites can help improve symptoms and reduce complications. In some patients, ascites may resolve with diuretic therapy or with TIPS or liver transplant. In the case of alcohol-associated hepatitis, ascites may resolve with improvements in liver function.

How do you control refractory ascites?

Therapy for refractory ascites is limited. The available therapies are repeated large volume paracentesis (LVP), transjugular intrahepatic portosystemic shunts, peritoneovenous shunts, investigational medical therapies, and liver transplantation. LVP with concomitant volume expanders is the initial treatment of choice.

What is the difference between ascites and refractory ascites?

Refractory ascites is defined as ascites that does not recede or that recurs shortly after therapeutic paracentesis, despite sodium restriction and diuretic treatment. To date, there is no approved medical therapy specifically for refractory ascites.

What is the prognosis of refractory ascites after liver transplant?

Objectives: Refractory ascites after liver transplant commonly occurs in living donor liver transplant (LDLT). Refractory ascites is associated with postoperative complications and poor prognosis. This study sought to determine the risk factors of refractory ascites and discuss their perioperative management.

Is persistent ascites a possible complication of orthotopic liver transplantation?

Background: Persistent ascites is an uncommon complication after orthotopic liver transplantation (OLT). Data on etiology, treatment and outcome are limited. Material and methods: Data on 691 orthotopic liver transplantations in 585 patients were reviewed retrospectively.

What is the first presentation of refractory ascites?

Finally, multiple early recurrence of ascites, which is usually seen within 4 weeks of fluid mobilization, may be the first presentation of refractory ascites in many patients.3 Table 1 Diagnostic Criteria of Refractory Ascites

Is there a cure for refractory ascites?

Abstract. To date, there is no approved medical therapy specifically for refractory ascites. Management of these patients is based upon procedures such as large-volume paracentesis and transjugular intrahepatic portosystemic shunts (TIPS), which temporarily alleviate symptoms but are not curative.