title: Pediatric liver transplant outcome using severe hypernatremic donors.
abstract: BACKGROUND
  Pediatric liver transplantation is limited by donation. In the last 5 years, urgent conditions have forced transplant teams to accept donors with minor suboptimal conditions, termed "extended donor criteria." Among those, the risk of using severe hypernatremic donors (SHD) for liver transplant is not yet well established. The aim of this study is to report the outcome of pediatric patients receiving grafts from SHD.
  
  
  METHODS
  Clinical records of patients transplanted in the last 3 years at Hospital Luis Calvo Mackenna, Santiago, Chile, were reviewed. Outcome was evaluated in terms of patient and graft survival and complications potentially associated to the donor condition.
  
  
  RESULTS
  Five of 33 deceased donor transplants presented with SHD. All recipients were waiting transplant in an acute condition, one of them in acute liver failure (ALF). No living related donor was available. Donors' serum sodium was 169 to 193 mEq/L before medical management and between 157 and 172 mEq/L at procurement. One patient died from sepsis related to biliary complications, and the patient suffering ALF developed primary graft nonfunction, received a second transplant 2 weeks later, and recovered to stable medical condition. No other complication was registered in these patients.
  
  
  CONCLUSIONS
  Our findings allow us to postulate that hypernatremic deceased donors may be used for pediatric liver transplant under special circumstances.
authors: Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile. Electronic address: muribem@clc.cl.
authors: M
authors: M
authors: Uribe
authors: A
authors: A
authors: Alba
authors: G
authors: G
authors: González
authors: B
authors: B
authors: Hunter
authors: C
authors: C
authors: Heine
authors: R
authors: R
authors: Iñiguez
authors: S
authors: S
authors: Cavallieri
authors: L
authors: L
authors: Flores
authors: P
authors: P
authors: Soto
authors: H
authors: H
authors: Auad
authors: R
authors: R
authors: Zuleta
authors: C
authors: C
authors: Acuña
mesh_terms: D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002102:Cadaver; D002648:Child; D002677:Chile; D046148:Donor Selection; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D012720:Severity of Illness Index; D012964:Sodium / Q000097:blood; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D015415:Biomarkers; D012964:Sodium