Cor Vasa 2005, 46(11):414-416
Effect of donor hypernatremia on graft function in the early post-transplant period
- Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika
Aim:
As sodium plays an important role in reperfusion injury, the hearts of donors with increased sodium levels are considered marginal. In theory, hypernatremia may result in myocardial stunning and, consequently, in a higher incidence of primary graft failure. Our study was designed to establish whether increased donor sodium levels have an effect on the qual-ity of the harvested heart graft.
Method:
We made a retrospective analysis of data of 159 patients undergoing heart transplantation (HTx) in our center from July 1995 through June 2003. Our endpoints included primary graft failure, increased circulatory support with catecholamines (CAT), intra-aortic balloon counterpulsation (IABC), incidence of acute rejection episodes and in-hospital mortality. We compared group A with normonatremia (131-145 mmol/l; 61 patients) with groups B showing mild hypernatremia (146-155 mmol/l; 50 patients) and C showing severe hypernatremia (156-188 mmol/l; 48 patients). Both the groups of pa-tients and the grafts used in them did not differ of any relevant feature. Statistical analysis was performed using contingency multiple field tables.
Results:
Primary graft failure occurred in a total of 9 patients (5.7%), with three cases in each group. Increased CAT
support and IABC were required by 13 patients of group A, and by nine patients of groups B and C each. There was no
significantly increased incidence of rejection episodes or in-hospital mortality in any of the study groups.
Conclusion:
We did not demonstrate an effect of increased donor sodium levels on early post-transplant outcome (CAT, IABC, rejection episodes, primary afunction) or short-term patient survival rates. As a result, donor grafts with increased sodium levels can be successfully transplanted without any concern about poor post-transplant results.
Keywords: Hypernatremia; Heart transplantation; Short-term survival; Rejection episode
Published: November 1, 2005 Show citation