Postoperative Hemodynamic Stabilization with Terlipressin: A Case of Liver Transplantation

Abstract

This report presents the successful management of a patient with acute liver failure on the background of chronic liver disease who underwent liver transplantation. Terlipressin, a vasoactive agent, managed hepatorenal syndrome and acute kidney injury by promoting splanchnic vasoconstriction and intrahepatic vasodilation, improving renal blood flow and hemodynamic stability. The case involves a 41-year-old woman with autoimmune hepatitis and primary biliary cirrhosis who required triple vasoactive therapy postoperatively. Bolus doses of terlipressin reduced the need for other vasopressors, stabilized renal function, and facilitated her recovery. This case underscores the potential of terlipressin as a valuable therapeutic option in the postoperative management of liver transplantation patients with refractory hemodynamic instability. Careful dosing and monitoring are essential to optimize outcomes and minimize risks. © 2025 Ondokuz Mayis Universitesi. All rights reserved.