title: The controversy of donor serum sodium levels in heart transplantation--a multicenter experience.
abstract: BACKGROUND
  Elevated donor serum sodium is a phenomenon often encountered in the management of brain dead donors. The clinical relevance on recipient outcome is less examined. We investigated the impact of elevated donor serum sodium levels (DSL) on outcome after heart transplantation in 1800 heart transplantations.
  
  
  METHODS
  Data was conducted in a retrospective analysis from 1989 until 2005. The transplantations were performed at three German heart transplant centers. The joined database included DSL at the time of organ procurement, recipient and donor age, ischemia time, primary graft failure and survival data.
  
  
  RESULTS
  Mean DSL was 147.7 +/- 10.3 l/l (range 111 - 208 l/l). Recipients were divided into 4 groups with percentiles of 141, 147, and 154 l/l resulting in DSL of A: 135.8 +/- 4.4, B: 143.6 +/- 1.7, C: 149.7 +/- 1.9, and D: 161.3 +/- 7.7 l/l for the four quartiles. Primary graft failure occurred in 2.6 % of the patients with A: 2.8 %, B: 2.8 %, C: 3.7% and D: 1.4 % ( P = n.s.). Mean 5- and 10-year-survival rates were 70.9 % (57.6 %) with A: 71.1 % (53.86 %), B: 69.3 % (53.9 %), C: 72.7 % (61.0 %), D: 71.2 % (62.4 %), respectively ( P = n. s.). In a multivariate analysis a significant impact on postoperative results could be revealed for recipient age ( P = 0.002), ischemia time ( P = 0.002) and donor age ( P = 0.009). DSL were no individual risk factor in the multivariate analysis.
  
  
  CONCLUSIONS
  There was no impact of donor serum sodium levels neither on early postoperative results, nor on long-term outcome indicating that cardiac allografts from donors with elevated sodium levels might be transplanted successfully, achieving favourable results.
authors.affiliation: Department of Cardiac Surgery, Ludwig-Maximilians-University, Marchioninistrasse 15, 81377 Münich, Germany. Ingo.Kaczmarek@med.uni-muenchen.de
authors.forename: I
authors.initials: I
authors.lastname: Kaczmarek
authors.forename: G
authors.initials: G
authors.lastname: Tenderich
authors.forename: J
authors.initials: J
authors.lastname: Groetzner
authors.forename: M-A
authors.initials: MA
authors.lastname: Deutsch
authors.forename: U
authors.initials: U
authors.lastname: Schulz
authors.forename: A
authors.initials: A
authors.lastname: Beiras-Fernandez
authors.forename: B
authors.initials: B
authors.lastname: Meiser
authors.forename: T
authors.initials: T
authors.lastname: Wahlers
authors.forename: R
authors.initials: R
authors.lastname: Koerfer
authors.forename: B
authors.initials: B
authors.lastname: Reichart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001926:Brain Death / Q000097:blood; D005500:Follow-Up Studies; D005858:Germany; D006084:Graft Rejection / Q000097:blood / Q000401:mortality; D016027:Heart Transplantation; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood*; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D012964:Sodium