Influence of preoperative sodium concentration on outcome of patients with hepatitis B virus cirrhosis after liver transplantation

Eur J Gastroenterol Hepatol. 2016 Oct;28(10):1210-5. doi: 10.1097/MEG.0000000000000690.

Abstract

Objectives: Whether preoperative serum sodium concentration could influence post-transplant patients' prognosis remains controversial. The aim of this study was to evaluate the influence of patients' pretransplant sodium concentration on the prognosis after liver transplantation in a cohort of patients with hepatitis B virus-related cirrhosis.

Patients and methods: Data derived from the Chinese Liver Transplantation Registry system from 1 January 2000 to 31 December 2011 were extracted. The serum sodium concentrations and model for end-stage liver disease scores were recorded at listing before liver transplantation, and the relationship between the above parameters and patients' outcome was analyzed.

Results: A total of 2733 patients were included in this study. Compared with patients in the normal group (serum sodium between 135 and 150 mmol/l), patients in the severe hyponatremia group (<125 mmol/l) (P=0.022) and hypernatremia group (>150 mmol/l) (P=0.008) had a poorer prognosis. No significant differences were found among the moderate hyponatremia group (125-130 mmol/l) (P=0.113) and the mild hyponatremia group (130-135 mmol/l) (P=0.461). The 5-year cumulative survivals for the hyponatremia (≤135 mmol/l), normal (135-150 mmol/l), and hypernatremia (≥150 mmol/l) pretransplant group are 79.52, 82.23, and 69.30%, respectively.

Conclusion: Our analysis showed that for patients with hepatitis B virus-related cirrhosis in mainland China, patients with abnormal serum sodium concentrations have poorer prognosis; both preoperative hyponatremia and hypernatremia were identified as negative risk factors for patients' outcome.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Chi-Square Distribution
  • China
  • Female
  • Hepatitis B / blood
  • Hepatitis B / complications
  • Hepatitis B / mortality
  • Hepatitis B / surgery*
  • Humans
  • Hypernatremia / blood*
  • Hypernatremia / complications
  • Hypernatremia / mortality
  • Hyponatremia / blood*
  • Hyponatremia / complications
  • Hyponatremia / mortality
  • Kaplan-Meier Estimate
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / surgery*
  • Liver Cirrhosis / virology
  • Liver Transplantation* / adverse effects
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sodium / blood*
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Sodium