Scimago Lab
powered by Scopus
call: +1.631.629.4327
Mon-Fri 10 am - 2 pm EST


Medical Science Monitor Basic Research


eISSN: 2329-0358

Get your full text copy in PDF

Prognostic Impact of Peritransplant Serum Sodium Concentrations in Liver Transplantation

Plamen Mihaylov, Shunji Nagai, Burcin Ekser, Richard Mangus, Jonathan Fridell, Chandrashekhar Kubal

(Transplant Division, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA)

Ann Transplant 2019; 24:418-425

DOI: 10.12659/AOT.914951

BACKGROUND: Serum sodium (Na) is considered to reflect the severity of liver cirrhosis. In the last few years, much effort has been made to integrate this association into prognostic models after liver transplantation. The aim of this study was to investigate the associations between peritransplant Na and neurological complications, as well as short-term survival, after liver transplantation.
MATERIAL AND METHODS: A total of 306 liver transplantations between 2012 and 2015 were evaluated. Pre- and posttransplant sodium concentrations were investigated with regard to 3-month survival and incidence of posttransplant neurological complications, along with other factors present in the operative side of the recipient and donor.
RESULTS: The 3-month survival rate was 94%. Neither hyponatremia (<130 mEq/L) nor hypernatremia (>145 mEq/L) at pretransplantion predicted 3-month survival. A large amount of intraoperative blood transfusion and a large delta Na showed a significant association with poor outcomes at 3 months. On multivariate analysis, the requirement of blood transfusion and warm ischemia time remained independent prognostic factors for 3-month mortality. Hyponatremia and a large delta Na tended to lead to the frequent development of neurological complications. These complications, secondary to rapid Na correction, were concerning and potentially led to a prolonged hospital stay and early mortality.
CONCLUSIONS: Rapid change in the sodium level might be caused by large amounts of blood transfusion products. This leads to a diminished short-term survival, as well as a higher rate of neurological complications.

Keywords: Hyponatremia, Liver Cirrhosis, Liver Transplantation

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree