ABSTRACT

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.

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.

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.

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.

Keywords: Liver Transplantation, Sodium, Postoperative Complication, Survival