# Prolonged Terlipressin Therapy as a Bridge to Curative TIPS for HRS–AKI in a Nontransplant Candidate

## TL;DR

The paper presents a case where terlipressin therapy successfully bridged a patient with severe liver disease to a curative treatment without needing a transplant.

## Contribution

It demonstrates the safety and effectiveness of prolonged terlipressin therapy as a bridge to TIPS in a nontransplant candidate with HRS–AKI.

## Key findings

- Terlipressin therapy was safely used to manage HRS–AKI before TIPS placement.
- TIPS provided definitive treatment for HRS–AKI in a nontransplant candidate.
- The combination approach improved outcomes in a patient ineligible for liver transplantation.

## Abstract

Hepatorenal syndrome–acute kidney injury (HRS–AKI) is a severe complication of advanced cirrhosis with high mortality and limited treatment options. Terlipressin is currently the only FDA‐approved therapy for HRS, though recurrence is common upon discontinuation in patients without access to liver transplantation. Transjugular intrahepatic portosystemic shunt (TIPS) may provide definitive treatment for HRS–AKI in nontransplant candidates or in the setting of prolonged waitlists. This case illustrates the safety and success of terlipressin prior to TIPS for definitive treatment of HRS–AKI in a nontransplant candidate.