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Year 2022, Volume: 75 Issue: 3, 328 - 334, 18.10.2022
https://doi.org/10.4274/atfm.galenos.2022.38243

Abstract

Project Number

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References

  • 1. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality amongpatients on the liver-transplant waiting list. N Engl J Med. 2008;359:1018-1026.
  • 2. Angeli P, Wong F, Watson H, et al. Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology. 2006;44:1535-1542.
  • 3. Ruf AE, Kremers WK, Chavez LL, et al. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl. 2005;11:336-343.
  • 4. Biggins SW, Rodriguez HJ, Bacchetti P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41:32-39.
  • 5. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130:1652-1660.
  • 6. Hudcova J, Ruthazer R, Bonney I, et al. Sodium homeostasis during liver transplantation and correlation with outcomes. Anesth Analg. 2014;119:1420-1428.
  • 7. Park C, Kim D, Choi J, et al. Intraoperative changes in hyponatremia as a risk factor for prolonged mechanical ventilation after living donor liver transplantation. Transplant Proc. 2010;42:3612-3616.
  • 8. Leise MD, Yun BC, Larson JJ, et al. Effect of the pretransplant serum sodium concentration on outcomes following liver transplantation. Liver Transpl. 2014;20:687-697.
  • 9. Ginès P, Guevara M. Hyponatremia in cirrhosis: pathogenesis, clinical significance, and management. Hepatology. 2008;48:1002-1010.
  • 10. Bernardi M, Zaccherini G. Approach and management of dysnatremias in cirrhosis. Hepatol Int. 2018;12:487-499.
  • 11. Yun BC, Kim WR, Benson JT, et al. Impact of pretransplant hyponatremia on outcome following liver transplantation. Hepatology. 2009;49:1610-1615.
  • 12. Londoño MC, Guevara M, Rimola A, et al. Hyponatremia impairs early posttransplantation outcome in patients with cirrhosis undergoing liver transplantation. Gastroenterology. 2006;130:1135-1143.
  • 13. Dawwas MF, Lewsey JD, Neuberger JM, et al. The impact of serum sodium concentration on mortality after liver transplantation: a cohort multicenter study. Liver Transpl. 2007;13:1115-1124.
  • 14. Brandman D, Biggins SW, Hameed B, et al. Pretransplant severe hepatic encephalopathy, peritransplant sodium and post-liver transplantation morbidity and mortality. Liver Int. 2012;32:158-164.
  • 15. Mihaylov P, Nagai S, Ekser B, et al. Prognostic Impact of Peritransplant Serum Sodium Concentrations in Liver Transplantation. Ann Transplant. 2019;24:418-425.
  • 16. Berry K, Copeland T, Ku E, et al. Perioperative Delta Sodium and Post- Liver Transplant Neurological Complications in Liver Transplant Recipients. Transplantation. 2022;106:1609-1614.
  • 17. Lee J, Kim DK, Lee JW, et al. Rapid correction rate of hyponatremia as an independent risk factor for neurological complication following liver transplantation. Tohoku J Exp Med. 2013;229:97-105.
  • 18. Yu J, Zheng SS, Liang TB, et al. Possible causes of central pontine myelinolysis after liver transplantation. World J Gastroenterol. 2004;10:2540-2543.

Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması

Year 2022, Volume: 75 Issue: 3, 328 - 334, 18.10.2022
https://doi.org/10.4274/atfm.galenos.2022.38243

Abstract

Objectives: Liver transplantation provides cure and improves the quality of life in patients with end-stage liver failure. But in these group of patients metabolic and electrolyte abnormalities are frequently seen as well as many organ system disorders. In this study, we aimed to investigate the effect of preoperative changes in sodium (Na) values on patient outcomes in patients undergoing liver transplantation.

Materials and Methods: The files of patients older than 18 years who underwent liver transplantation from living donors between January 2014 and June 2019 were retrospectively examined. Demographic data of the patients, primary disease causing liver failure, CTP score, MELD score and surgery data were recorded. Hyponatremia, normonatremia and hypernatremia were defined as Na≤130 mEq/L, 131-145 mEq/L and >145 mEq/L, respectively. The difference between the preoperative Na value and the first postoperative Na value was calculated as Delta-Na (ΔNa). Early
complications and mortality rates were noted.

Results: One hundred seventeen patients were included in our study. Of these patients, 35.9% were female, 64.1% were male and the mean age was 50.18±12.25. The mean MELD-Na score of the patients was 19.58±7.46. The complication rate was higher in patients with ΔNa>10 mEq/L than in patients with ΔNa=5-10 mEq/L and ΔNa<5 mEq/L (p=0.039, p=0.011, respectively). The length of intensive care unit stay (7.78±7.63 days) was longer in patients with ΔNa±5 mEq/L and ΔNa=5-10 mEq/L (4.51±4.08 days and 5.22±5.16 days) (p=0.032). The complication rate was similar to the
duration of intensive care and hospital stay (p<0.05) for all patients. In the preoperative period, changes in sodium level and ΔNa level did not have
an effect on mortality in the first 90 days postoperatively.

Conclusion: We believe that changes in sodium value in patients undergoing liver transplantation from living donors may lead to increased complications and prolonged intensive care unit stays.

Key Words: Liver Transplantation, Sodium, Postoperative Complication, Survival

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Thanks

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References

  • 1. Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality amongpatients on the liver-transplant waiting list. N Engl J Med. 2008;359:1018-1026.
  • 2. Angeli P, Wong F, Watson H, et al. Hyponatremia in cirrhosis: Results of a patient population survey. Hepatology. 2006;44:1535-1542.
  • 3. Ruf AE, Kremers WK, Chavez LL, et al. Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone. Liver Transpl. 2005;11:336-343.
  • 4. Biggins SW, Rodriguez HJ, Bacchetti P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41:32-39.
  • 5. Biggins SW, Kim WR, Terrault NA, et al. Evidence-based incorporation of serum sodium concentration into MELD. Gastroenterology. 2006;130:1652-1660.
  • 6. Hudcova J, Ruthazer R, Bonney I, et al. Sodium homeostasis during liver transplantation and correlation with outcomes. Anesth Analg. 2014;119:1420-1428.
  • 7. Park C, Kim D, Choi J, et al. Intraoperative changes in hyponatremia as a risk factor for prolonged mechanical ventilation after living donor liver transplantation. Transplant Proc. 2010;42:3612-3616.
  • 8. Leise MD, Yun BC, Larson JJ, et al. Effect of the pretransplant serum sodium concentration on outcomes following liver transplantation. Liver Transpl. 2014;20:687-697.
  • 9. Ginès P, Guevara M. Hyponatremia in cirrhosis: pathogenesis, clinical significance, and management. Hepatology. 2008;48:1002-1010.
  • 10. Bernardi M, Zaccherini G. Approach and management of dysnatremias in cirrhosis. Hepatol Int. 2018;12:487-499.
  • 11. Yun BC, Kim WR, Benson JT, et al. Impact of pretransplant hyponatremia on outcome following liver transplantation. Hepatology. 2009;49:1610-1615.
  • 12. Londoño MC, Guevara M, Rimola A, et al. Hyponatremia impairs early posttransplantation outcome in patients with cirrhosis undergoing liver transplantation. Gastroenterology. 2006;130:1135-1143.
  • 13. Dawwas MF, Lewsey JD, Neuberger JM, et al. The impact of serum sodium concentration on mortality after liver transplantation: a cohort multicenter study. Liver Transpl. 2007;13:1115-1124.
  • 14. Brandman D, Biggins SW, Hameed B, et al. Pretransplant severe hepatic encephalopathy, peritransplant sodium and post-liver transplantation morbidity and mortality. Liver Int. 2012;32:158-164.
  • 15. Mihaylov P, Nagai S, Ekser B, et al. Prognostic Impact of Peritransplant Serum Sodium Concentrations in Liver Transplantation. Ann Transplant. 2019;24:418-425.
  • 16. Berry K, Copeland T, Ku E, et al. Perioperative Delta Sodium and Post- Liver Transplant Neurological Complications in Liver Transplant Recipients. Transplantation. 2022;106:1609-1614.
  • 17. Lee J, Kim DK, Lee JW, et al. Rapid correction rate of hyponatremia as an independent risk factor for neurological complication following liver transplantation. Tohoku J Exp Med. 2013;229:97-105.
  • 18. Yu J, Zheng SS, Liang TB, et al. Possible causes of central pontine myelinolysis after liver transplantation. World J Gastroenterol. 2004;10:2540-2543.
There are 18 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Research Article
Authors

Tuçe Merve Kalaycı This is me 0000-0003-3189-6164

Süheyla Karadağ Erkoç 0000-0001-5086-5916

Ali Abbas Yılmaz 0000-0001-7629-2802

Project Number -
Publication Date October 18, 2022
Published in Issue Year 2022 Volume: 75 Issue: 3

Cite

APA Kalaycı, T. M., Karadağ Erkoç, S., & Yılmaz, A. A. (2022). Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(3), 328-334. https://doi.org/10.4274/atfm.galenos.2022.38243
AMA Kalaycı TM, Karadağ Erkoç S, Yılmaz AA. Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 2022;75(3):328-334. doi:10.4274/atfm.galenos.2022.38243
Chicago Kalaycı, Tuçe Merve, Süheyla Karadağ Erkoç, and Ali Abbas Yılmaz. “Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75, no. 3 (October 2022): 328-34. https://doi.org/10.4274/atfm.galenos.2022.38243.
EndNote Kalaycı TM, Karadağ Erkoç S, Yılmaz AA (October 1, 2022) Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 3 328–334.
IEEE T. M. Kalaycı, S. Karadağ Erkoç, and A. A. Yılmaz, “Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, pp. 328–334, 2022, doi: 10.4274/atfm.galenos.2022.38243.
ISNAD Kalaycı, Tuçe Merve et al. “Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/3 (October2022), 328-334. https://doi.org/10.4274/atfm.galenos.2022.38243.
JAMA Kalaycı TM, Karadağ Erkoç S, Yılmaz AA. Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:328–334.
MLA Kalaycı, Tuçe Merve et al. “Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 75, no. 3, 2022, pp. 328-34, doi:10.4274/atfm.galenos.2022.38243.
Vancouver Kalaycı TM, Karadağ Erkoç S, Yılmaz AA. Karaciğer Nakli Hastalarında Preoperatif Sodyum Değerlerinin Postoperatif Döneme Etkilerinin Araştırılması. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(3):328-34.