title: Early outcomes of liver transplants in patients receiving organs from hypernatremic donors.
abstract: OBJECTIVE
  Uncorrected hypernatremia in organ donors has been associated with poor graft or patient survival during liver transplants. However, recent studies have found no association between the donor serum sodium and transplant outcome. This study sought to show the negative effect donor hypernatremia has on initial liver allograft function. This is the first study to investigate international normalized ratio and renal factors of patients with normal and those with hypernatremic donor livers.
  
  
  METHODS
  This study was conducted at the Shiraz Transplant Research Center in Shiraz, Iran, between May 2009, and July 2011. Four hundred seven consecutive adult orthotopic liver transplants were performed at the University of Shiraz Medical Center.
  
  
  RESULTS
  There were 93 donors in the group with hypernatremia with terminal serum sodium of 155 mEq/L or greater (group 1), and 314 with terminal serum sodium less than 155 mEq/L (group 2). Posttransplant data after 5 days showed that aspartate aminotransferase, alanine aminotransferase, international normalized ratio, and kidney function did not differ between the groups.
  
  
  CONCLUSIONS
  Hypernatremia is the most important complication after brain death. Previous studies have suggested donor hypernatremia results in a greater incidence of early postoperative graft dysfunction in liver transplant and is considered one of the extended criteria donor. However, in recent years, this hypothesis has been questioned. Our study shows no difference between patients' initial results of liver and kidney functioning with normal and hypernatremic donor livers. This is the first study to investigate international normalized ratio as a fundamental factor in defining early allograft dysfunction and renal factors between patients with normal and hypernatremic donor's livers.
authors.affiliation: Shiraz University of Medical Sciences, Department of Anesthesiology and Critical Care, Anesthesiology and Critical Care Research Center, Nemazi Hospital, Shiraz, Iran.
authors.forename: Mohammad Bagher
authors.initials: MB
authors.lastname: Khosravi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Firoozifar
authors.forename: Sina
authors.initials: S
authors.lastname: Ghaffaripour
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sahmeddini
authors.forename: Mohammad Hossien
authors.initials: MH
authors.lastname: Eghbal
mesh_terms: D000328:Adult; D064591:Allografts; D015331:Cohort Studies; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006801:Humans; D006955:Hypernatremia / Q000150:complications*; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012964:Sodium / Q000097:blood; D015996:Survival Rate; D014019:Tissue Donors; D014180:Transplantation; D016896:Treatment Outcome
chemical_list: D012964:Sodium