Prognostic Impact of Peritransplant Serum Sodium Concentrations in Liver Transplantation.

Publisher: International Scientific Literature, Inc Country of Publication: United States NLM ID: 9802544 Publication Model: Electronic Cited Medium: Internet ISSN: 2329-0358 (Electronic) Linking ISSN: 14259524 NLM ISO Abbreviation: Ann Transplant Subsets: MEDLINE

Publication: <2013- > : Smithtown, New York: International Scientific Literature, Inc.
Original Publication: Warsaw : Polish Transplantology Foundation : Transplantation Institute, Warsaw Medical School, 1996-

Liver Cirrhosis/*surgery ; Liver Transplantation/*adverse effects ; Postoperative Complications/*etiology ; Sodium/*blood; Female ; Humans ; Hypernatremia/blood ; Hypernatremia/complications ; Hyponatremia/blood ; Hyponatremia/complications ; Liver Cirrhosis/blood ; Liver Cirrhosis/complications ; Liver Transplantation/mortality ; Male ; Middle Aged ; Postoperative Complications/mortality ; Prognosis ; Retrospective Studies ; Survival Rate

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.

Clin Neuropharmacol. 2000 Mar-Apr;23(2):110-3. (PMID: 10803802)
World J Gastroenterol. 2004 Sep 1;10(17):2540-3. (PMID: 15300900)
Gastroenterology. 2006 May;130(6):1652-60. (PMID: 16697729)
Hepatology. 2008 Sep;48(3):1002-10. (PMID: 18671303)
N Engl J Med. 2008 Sep 4;359(10):1018-26. (PMID: 18768945)
Transpl Int. 2009 Mar;22(3):269-78. (PMID: 19076332)
Transplantation. 2010 Aug 27;90(4):438-43. (PMID: 20679966)
Ann Pharmacother. 2011 Feb;45(2):e10. (PMID: 21304032)
Liver Transpl. 2012 Jul;18(7):786-95. (PMID: 22237953)
Tohoku J Exp Med. 2013;229(2):97-105. (PMID: 23303272)
Transplant Proc. 2014 Jun;46(5):1393-9. (PMID: 24935303)
Eur J Neurol. 2014 Dec;21(12):1443-50. (PMID: 25220878)
Liver Transpl. 2015 Mar;21(3):308-13. (PMID: 25504743)
N Engl J Med. 1986 Jun 12;314(24):1535-42. (PMID: 3713747)
Hepatogastroenterology. 1998 Jul-Aug;45(22):1026-33. (PMID: 9756002)
Arch Surg. 1999 Jan;134(1):25-9. (PMID: 9927126)

9NEZ333N27 (Sodium)

Date Created: 20190717 Date Completed: 20200131 Latest Revision: 20200225

20231215

PMC6659455

10.12659/AOT.914951

31308357