Influence of preoperative sodium concentration on outcome of patients with hepatitis B virus cirrhosis after liver transplantation

Objectives Whether preoperative serum sodium concentration could influence post-transplant patients' prognosis remains controversial. The aim of this study was to evaluate the influence of patients' pretransplant sodium concentration on the prognosis after liver transplantation in a cohort of patients with hepatitis B virus-related cirrhosis. Patients and methods Data derived from the Chinese Liver Transplantation Registry system from 1 January 2000 to 31 December 2011 were extracted. The serum sodium concentrations and model for end-stage liver disease scores were recorded at listing before liver transplantation, and the relationship between the above parameters and patients' outcome was analyzed. Results A total of 2733 patients were included in this study. Compared with patients in the normal group (serum sodium between 135 and 150 mmol/l), patients in the severe hyponatremia group (<125 mmol/l) (P=0.022) and hypernatremia group (>150 mmol/l) (P= 0.008) had a poorer prognosis. No significant differences were found among the moderate hyponatremia group (125-130 mmol/l) (P =0.113) and the mild hyponatremia group (130-135 mmol/l) (P= 0.461). The 5-year cumulative survivals for the hyponatremia (≤135 mmol/l), normal (135-150 mmol/l), and hypernatremia (≥150 mmol/l) pretransplant group are 79.52, 82.23, and 69.30%, respectively. Conclusion Our analysis showed that for patients with hepatitis B virus-related cirrhosis in mainland China, patients with abnormal serum sodium concentrations have poorer prognosis; both preoperative hyponatremia and hypernatremia were identified as negative risk factors for patients' outcome.