GHÉP GAN CẤP CỨU Ở BỆNH NHÂN XƠ GAN DO VIRUS VIÊM GAN B CÓ HỘI CHỨNG GAN THẬN: BÁO CÁO CA LÂM SÀNG

Abstract

Objectives: To present a clinical case of hepatitis B virus-related (HBV) cirrhosis that developed hepatorenal syndrome - acute kidney injury (HRS-AKI), managed with hemodialysis, plasma exchange, and subsequent liver transplantation; and to discuss diagnostic challenges, therapeutic strategies, and renal function recovery after transplantation. Methods: A case report was conducted on a patient with HRS-AKI who underwent emergency liver transplantation. Results: A 41-year-old male with cirrhosis due to chronic HBV infection, with poor treatment adherence, was admitted in a state of altered consciousness, ascites, and oliguria. Laboratory findings revealed severe progressive hepatic dysfunction and renal impairment. The patient was diagnosed with HRS-AKI after exclusion of other causes of acute kidney injury. Vasoconstrictor therapy and albumin infusion were unsuccessful, necessitating continuous renal replacement therapy and plasma exchange. Emergency liver transplantation was performed 10 days after admission. Five days post-transplant, liver function recovered significantly, and renal function gradually improved, eliminating the need for further dialysis. Conclusion: This case demonstrates that emergency liver transplantation is a life-saving option for patients with HRS-AKI unresponsive to medical therapy. It further highlights the importance of early diagnosis and timely referral to a transplant center.