Clinical study of chronic hyponatremia after liver transplantation / 器官移植

ABSTRACT

Objective To summarize clinical characteristics, prevention and treatment of postoperative chronic hyponatremia after liver transplantation(LT). Methods Clinical data of 26 patients presenting with chronic hyponatremia after LTwereretrospectivelyanalyzed.BaselinedataandmaincomplicationsofpatientswithhyponatremiaafterLTwererecorded. Thecorrelationbetweenpostoperativelengthofhospitalstayandthedurationofhyponatremiawasanalyzed.Clinicaltreatment and prognosis were summarized. Results Among 26 patients, the median blood sodium concentration was 131 mmol/L (range 125 to 133 mmol/L). Al patients were diagnosed with mild or moderate degree of hyponatremia. Main complications included pulmonary infection (n=13, 50%), acute rejection of liver graft (n=7, 27%) and digestive tract hemorrhage (n=7, 27%). Postoperative length of hospital stay was correlated with the duration of hyponatremia. After ful evaluation of patient's conditionandexcludingthepotentialinducers,aportionof3%ofhypertonicsalinewasadministeredviagastro-intestinaltract and/or vein. After positive treatment, 23 cases (88%) were healed and 3 (12%) died from infection complicated with multiple organ failure. Conclusions After LT, the incidence of chronic hyponatremia is low with mild severity. Postoperative length of hospitalstayiscorrelatedwiththedurationofhyponatremia.Thekeyoftreatmentistotimelyexcludetheinducers,correctthe low level of sodium based upon the individual principles and prevent the incidence of postoperative complications.