Impact of preoperative serum sodium concentration in living donor liver transplantatio

Takasuke Fukuhara, Toru Ikegami, Kazutoyo Morita, Kenji Umeda, Shigeru Ueda, Shigeyuki Nagata, Keishi Sugimachi, Tomonobu Gion, Tomoharu Yoshizumi, Yuji Soejima, Akinobu Taketomi, Yoshihiko Maehara

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and Aims: The importance of hyponatremia in deceased donor liver transplantation (DDLT) has been recently discussed frequently. However, its impact on the outcomes in living donor liver transplantation (LDLT) has not yet been elucidated. The current study was designed to demonstrate the impact of pre-transplant sodium concentration on postoperative clinical outcomes. Methods: One hundred and thirty-four patients who underwent LDLT for end-stage liver diseases were examined to evaluate the significance of pre-transplant hyponatremia (Na ≤ 130 mEq/L) on the short-term clinical outcomes and the efficacy of the Model for End-Stage Liver Disease and serum sodium (MELD-Na) score using the sodium concentration and original MELD score. Results: The preoperative sodium and MELD score for all patients were 133.9 mEq/L (range: 109-142) and 16.2 (range: 6-38), respectively. According to a multivariate analysis, not only the MELD score (P = 0.030) but also the sodium concentration (P = 0.005) were found to be significant predictive factors for short-term graft survival. Preoperative hyponatremia was a significant risk factor for the occurrence of sepsis (P < 0.001), renal dysfunction (P < 0.001) and encephalopathy (P = 0.026). The MELD-Na score was 19.6 (range: 6-51) and the area under the receiver-operator curve of that (c-statistics: 0.867) was higher than MELD score and sodium concentration (c-statistics: 0.820 and 0.842, respectively). Conclusion: Preoperative hyponatremia was a significant risk for postoperative complications and short-term graft loss. The addition of sodium concentration to MELD score might therefore be an effective predictor for post-transplant short-term mortality in LDLT.

Original languageEnglish
Pages (from-to)978-984
Number of pages7
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume25
Issue number5
DOIs
Publication statusPublished - May 2010

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Living Donors
Sodium
Hyponatremia
Liver
Liver Transplantation
Serum
Transplants
End Stage Liver Disease
Brain Diseases
Graft Survival
Sepsis
Multivariate Analysis
Tissue Donors
Kidney
Mortality

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Impact of preoperative serum sodium concentration in living donor liver transplantatio. / Fukuhara, Takasuke; Ikegami, Toru; Morita, Kazutoyo; Umeda, Kenji; Ueda, Shigeru; Nagata, Shigeyuki; Sugimachi, Keishi; Gion, Tomonobu; Yoshizumi, Tomoharu; Soejima, Yuji; Taketomi, Akinobu; Maehara, Yoshihiko.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 25, No. 5, 05.2010, p. 978-984.

Research output: Contribution to journalArticle

Fukuhara, T, Ikegami, T, Morita, K, Umeda, K, Ueda, S, Nagata, S, Sugimachi, K, Gion, T, Yoshizumi, T, Soejima, Y, Taketomi, A & Maehara, Y 2010, 'Impact of preoperative serum sodium concentration in living donor liver transplantatio', Journal of Gastroenterology and Hepatology (Australia), vol. 25, no. 5, pp. 978-984. https://doi.org/10.1111/j.1440-1746.2009.06162.x
Fukuhara, Takasuke ; Ikegami, Toru ; Morita, Kazutoyo ; Umeda, Kenji ; Ueda, Shigeru ; Nagata, Shigeyuki ; Sugimachi, Keishi ; Gion, Tomonobu ; Yoshizumi, Tomoharu ; Soejima, Yuji ; Taketomi, Akinobu ; Maehara, Yoshihiko. / Impact of preoperative serum sodium concentration in living donor liver transplantatio. In: Journal of Gastroenterology and Hepatology (Australia). 2010 ; Vol. 25, No. 5. pp. 978-984.
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AU - Fukuhara, Takasuke

AU - Ikegami, Toru

AU - Morita, Kazutoyo

AU - Umeda, Kenji

AU - Ueda, Shigeru

AU - Nagata, Shigeyuki

AU - Sugimachi, Keishi

AU - Gion, Tomonobu

AU - Yoshizumi, Tomoharu

AU - Soejima, Yuji

AU - Taketomi, Akinobu

AU - Maehara, Yoshihiko

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N2 - Background and Aims: The importance of hyponatremia in deceased donor liver transplantation (DDLT) has been recently discussed frequently. However, its impact on the outcomes in living donor liver transplantation (LDLT) has not yet been elucidated. The current study was designed to demonstrate the impact of pre-transplant sodium concentration on postoperative clinical outcomes. Methods: One hundred and thirty-four patients who underwent LDLT for end-stage liver diseases were examined to evaluate the significance of pre-transplant hyponatremia (Na ≤ 130 mEq/L) on the short-term clinical outcomes and the efficacy of the Model for End-Stage Liver Disease and serum sodium (MELD-Na) score using the sodium concentration and original MELD score. Results: The preoperative sodium and MELD score for all patients were 133.9 mEq/L (range: 109-142) and 16.2 (range: 6-38), respectively. According to a multivariate analysis, not only the MELD score (P = 0.030) but also the sodium concentration (P = 0.005) were found to be significant predictive factors for short-term graft survival. Preoperative hyponatremia was a significant risk factor for the occurrence of sepsis (P < 0.001), renal dysfunction (P < 0.001) and encephalopathy (P = 0.026). The MELD-Na score was 19.6 (range: 6-51) and the area under the receiver-operator curve of that (c-statistics: 0.867) was higher than MELD score and sodium concentration (c-statistics: 0.820 and 0.842, respectively). Conclusion: Preoperative hyponatremia was a significant risk for postoperative complications and short-term graft loss. The addition of sodium concentration to MELD score might therefore be an effective predictor for post-transplant short-term mortality in LDLT.

AB - Background and Aims: The importance of hyponatremia in deceased donor liver transplantation (DDLT) has been recently discussed frequently. However, its impact on the outcomes in living donor liver transplantation (LDLT) has not yet been elucidated. The current study was designed to demonstrate the impact of pre-transplant sodium concentration on postoperative clinical outcomes. Methods: One hundred and thirty-four patients who underwent LDLT for end-stage liver diseases were examined to evaluate the significance of pre-transplant hyponatremia (Na ≤ 130 mEq/L) on the short-term clinical outcomes and the efficacy of the Model for End-Stage Liver Disease and serum sodium (MELD-Na) score using the sodium concentration and original MELD score. Results: The preoperative sodium and MELD score for all patients were 133.9 mEq/L (range: 109-142) and 16.2 (range: 6-38), respectively. According to a multivariate analysis, not only the MELD score (P = 0.030) but also the sodium concentration (P = 0.005) were found to be significant predictive factors for short-term graft survival. Preoperative hyponatremia was a significant risk factor for the occurrence of sepsis (P < 0.001), renal dysfunction (P < 0.001) and encephalopathy (P = 0.026). The MELD-Na score was 19.6 (range: 6-51) and the area under the receiver-operator curve of that (c-statistics: 0.867) was higher than MELD score and sodium concentration (c-statistics: 0.820 and 0.842, respectively). Conclusion: Preoperative hyponatremia was a significant risk for postoperative complications and short-term graft loss. The addition of sodium concentration to MELD score might therefore be an effective predictor for post-transplant short-term mortality in LDLT.

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