Influence of donor blood sodium and donor-recipient blood sodium difference on patients after liver transplantation

Abstract:

Objective：To investigate the effect of donor blood sodium and donor-recipient blood sodium difference on patients after liver transplantation. Methods：A retrospective analysis was performed for the clinical data of 20 donors who underwent donor organ main－tenance and 20 patients who underwent liver transplantation in our hospital from July 2016 to May 2018. Related clinical data were analyzed. Results：There were no significant differences in the highest levels of total bilirubin，alanine aminotransferase（ALT），and aspartate aminotransferase（AST），recovery time of liver function，length of stay in the intensive care unit，and length of hospital stay after liver transplantation between the blood sodium >155 mmol/L donor group and the blood sodium <155 mmol/L donor group. According to donor blood sodium at the time of transplantation，the patients were divided into donor blood sodium >155 mmol/L group and donor blood sodium <155 mmol/L group，and the highest ALT level after surgery in the donor blood sodium <155 mmol/L group was significantly higher than that in the donor blood sodium >155 mmol/L group（747.17±375.34 U/L vs. 357.00±190.50 U/L，t=-2.700，P=0.015）. According to donor-recipient blood sodium difference（ΔNa），the patients were divided into ΔNa <10 mmol/L，ΔNa=10-20 mmol/L，and ΔNa >20 mmol/L groups，and there was a significant difference in the highest ALT level after liver transplantation between the three groups（805.00±332.90 U/L vs. 329.75±237.43 U/L vs. 329.60±186.21 U/L，F= 6.714，P=0.007）；the highest ALT level after liver transplantation in the ΔNa<10 mmol/L group was significantly higher than that in the other two groups（P=0.012 and 0.007），and there was no significant difference between the ΔNa=10-20 mmol/L group and the ΔNa>20 mmol/L group（P=0.999）. ΔNa was nega－tively correlated with the highest ALT level after liver trans－plantation（r=-0.579，P=0.007），and the highest ALT level after liver transplantation increased with the reduction in ΔNa. The linear regression analysis showed that model for end-stage liver disease（MELD） score was an independent risk factor for infec－tion after liver transplantation. Conclusion：Donor blood sodium <155 mmol/L may result in an increase in the highest ALT level after liver transplantation. The highest ALT level after liver transplantation increases with the reduction in ΔNa. MELD score is an inde－pendent risk factor for infection after liver transplantation.