Abstract: SA-PO1215
Hepatorenal Syndrome and the Effect of Liver Transplantation on In-Hospital Mortality
Session Information
- Transplantation: Clinical - Complications, Pediatrics, and Multi-Organ Considerations
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Author
- Velez-Oquendo, Gabriel, Northeast Georgia Health System Inc, Gainesville, Georgia, United States
Background
Hepatorenal syndrome (HRS) is a serious complication of advanced liver disease with high mortality. National trends in HRS hospitalizations and the impact of liver transplant on outcomes in contemporary practice are not well characterized.
Methods
Data was obtained from the National Inpatient Sample (NIS) 2016-2022 database to identify patient hospitalizations complicated by HRS using ICD-10-CM codes. Liver transplant during hospitalization was identified by using ICD-10-PCS procedure codes. We assessed demographic and clinical predictors, and primary outcomes including in-hospital mortality, length of stay, and costs. Logistic regression was used to assess factors associated with in-hospital mortality and with receipt of liver transplant; linear regression was used for LOS.
Results
A total of 178,765 hospitalizations with HRS were identified. Patients affected by HRS had a mean age of 59.3 years (SD 13.2) and were more likely to self-identify as Caucasian females. The proportion of HRS admissions receiving liver transplant during hospitalization increased over the study period (p<0.001). In multivariable logistic regression, liver transplant during admission was associated with substantially lower odds of in-hospital mortality (adjusted OR 0.10, 95% CI 0.08–0.14; p<0.001). In-hospital mortality showed a modest upward trend by calendar year (trend p=0.04). Recipients of liver transplant were younger (mean 53.4 vs 59.5 years) and had in-hospital mortality of 3.6% versus 26.4% and mean LOS of 33.7 versus 10.3 days for those without transplant.
Conclusion
HRS hospitalizations and liver transplantation among HRS admissions rose significantly; with liver transplant during admission strongly associated with lower in-hospital mortality. These findings underscore the importance of timely transplant evaluation in this high-risk population.
HRS trends including hospitalizations per year, mortality trend per year, admissions with liver transplant and length of stay.