Do you avoid terlipressin for patients with hepatorenal syndrome who have an elevated bilirubin level?

The CONFIRM trial excluded patients with Grade 3 acute on chronic liver failure (due to increased risk of pulmonary complications). There have also been concerns raised that using terlipressin on liver transplant candidates might improve their MELD score enough to jeopardize their spot on the waitin...

The improved MELD is taken into consideration as a drug effect, and transplant listing is made before terlipressin administration.