title: Hyponatremia a valuable predictor of early mortality in patients with cirrhosis listed for liver transplantation.
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.
authors.affiliation: Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. dornam@hotmail.com
authors.forename: Maryam
authors.initials: M
authors.lastname: Moini
authors.forename: Mohammad Kazem
authors.initials: MK
authors.lastname: Hoseini-Asl
authors.forename: Seyed Alireza
authors.initials: SA
authors.lastname: Taghavi
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Sagheb
authors.forename: Saman
authors.initials: S
authors.lastname: Nikeghbalian
authors.forename: Heshmatalah
authors.initials: H
authors.lastname: Salahi
authors.forename: Ali
authors.initials: A
authors.lastname: Bahador
authors.forename: Motahareh
authors.initials: M
authors.lastname: Motazedian
authors.forename: Peyman
authors.initials: P
authors.lastname: Jafari
authors.forename: Sayed Ali
authors.initials: SA
authors.lastname: Malek-Hosseini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology* / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D017093:Liver Failure; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012964:Sodium / Q000097:blood; D015996:Survival Rate; D014019:Tissue Donors; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult
chemical_list: D012964:Sodium