The Impact Of Donor Hypernatremia On Outcomes After OLT

Background:The available donor livers are in short supply,which facilitates a more open conception of expanded criteria donor(ECD)grafts including hypernatremia liver.At present,there is no studies adequately proved whether donor hypernatremia affect the survival after liver transplantation.Objective:This study was to research the influence of donor hypernatremia on the short and long-term survival after liver transplantation.Methods:23494 patients were selected from the Scientific Registry of Transplant Recipients database.Among them,1645 donors belong to hypernatremia which we defined as sodium ?160?mol/L.Among the baseline characteristics of donors and recipients,continuous variables were used the Student's t-test,categorical variables were the chi-square test.The Kaplan-Meier curves showed patient survival and graft survival,meantime log-rank tests was taken to compare with.Cox-proportional hazard models were created for the time-to-survival and time-to-graft loss to evaluate the potential predictors of the outcome measures.Results:Kaplan-Meier curves and log-rank tests showed that the survival of grafts using hypernatremia liver was lower than the other(one-year survival:78.1%versus 79.8%,three-year survival:70.4%versus 71.8%,and five-year survival:60.1%versus 65.6%,P<0.001,respectively),and the survival of patients using hypernatremia liver was lower than the other(one-year survival:74.6%versus 76.2%,three-year survival:68.4%versus 70.1%,and five-year survival:58.5%versus 61.7%,P<0.001,respectively).The hazard ratios of multivariate Cox regression models for donor hypernatremia were 1.164(95%CI = 1.054-1.511)and 1.212(95%CI = 1.034-1.389),respectively.Conclusion:Donor hypernatremia reduced graft and patient survival,and was a independent risk factor for OLT.