Serum Sodium Predicts Prognosis in Liver Transplant Patients

呂宜樺(Yi-Hua Lu) ； 李威震(Wei-Chen Lee) ； 王忠信(Chung-Shun Wong) ； 鄭昌錡(Chang-Chyi Jenq) ； 田亞中(Ya-Chung Tian) ； 張明揚(Ming-Yang Chang) ； 林展宇(Chan-Yu Lin) ； 陳永昌(Yung-Chang Chen) ； 方基存(Ji-Tseng Fang) ； 楊智偉(Chih-Wei Yang)

《Acta Nephrologica》 23卷3期 (2009/09) Pp. 164-170

摘要

無資料

關鍵字

Hyponatremia ； liver transplant ； cirrhosis

並列摘要

Background: Hyponatremia is common in advanced cirrhosis patients. This condition is associated with reduced survival in patients with end-stage liver disease awaiting liver transplantation. Hyponatremia has been proved as a posttransplantation outcome predictor in cirrhosis patient undergoing liver transplantation. This study assesses the prognostic value of serum sodium level, not only pre-operation but also post-operation, in liver transplant patients.
Methods: One hundred forty-nine consecutive cirrhosis patients who had received liver transplants during a 7-year period were enrolled in this study. Demographic data as well as pre- and post-transplant clinical and laboratory variables were retrospectively recorded.
Results: The overall 1-year mortality rate was 22.1%. Patients with pre-transplant serum sodium ≤135 mmol/L had significantly higher 1-month, 3-month, and 1-year mortality. In patients with serum sodium ≤135 mmol/L on Day 3 post-liver transplant, 1-year mortality was significantly increased, but 1-month and 3-month mortality were not. As a predictor of 3-month mortality, the discriminatory power of pre-transplant serum sodium concentration was superior to that of concentrations observed on post-transplant Day 1 and Day 3. For predicting 1-year mortality, the pre-transplant and post-transplant Day 3 serum sodium levels displayed better areas under the receiver operating characteristic curves than post-transplant Day 1 serum sodium concentration did. Finally, cumulative survival rates at 1-year follow-up differed significantly (p＜0.05) between patients with pre-transplant and post-transplant Day 3 serum sodium＞135 mmol/L and those with serum sodium ≤135 mmol/L.
Conclusions: Low serum sodium level at pre-transplant and at Day 3 post-transplant is associated with poor short-term prognosis. In cirrhosis patients, low sodium level should be considered a mortality risk factor before transplantation as well as a risk factor for poor early post-transplantation outcome.