Hyponatremia a valuable predictor of early mortality in patients with cirrhosis listed for liver transplantation |
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Authors: | Moini Maryam Hoseini-Asl Mohammad Kazem Taghavi Seyed Alireza Sagheb Mohammad M Nikeghbalian Saman Salahi Heshmatalah Bahador Ali Motazedian Motahareh Jafari Peyman Malek-Hosseini Sayed Ali |
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Affiliation: | Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. dornam@hotmail.com |
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Abstract: | The current policy for organ allocation in liver transplantation is to give priority to the sickest patients mostly using model for end-stage liver disease (MELD) score in ranking. However, other factors as serum sodium may be of value in predicting early mortality. In this single-center study, patients with cirrhosis over age 14 on the liver transplant wait-list from September 1998 to June 2007 were followed for six months from the time of listing to evaluate the value of hyponatremia on mortality. Of 612 listed patients, 51 were transplanted who were excluded from survival analysis and 55 died without transplantation within the first three months. The numbers of transplanted and dead patients during months 3-6 were 29 and 24, respectively. Both MELD score and serum sodium at the time of listing were independent predictors of early mortality. On bivariate analysis, serum sodium of <130 mEq/L beside MELD was a significant predictor of mortality within 90 and 180 d. Serum sodium level <135 mEq/L masked the difference in mortality between patients with refractory and non-refractory ascites. Serum sodium level of <130 mEq/L and an increased MELD score are significant predictors of early mortality in patients listed for liver transplantation. |
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Keywords: | ascites hyponatremia liver transplant waiting list model for end‐stage liver disease mortality |
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