Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation
Clin. transplant
; 33(10)8 Sept. 2019.
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1009490
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
INTRODUCTION:
Primary graft failure (PGF) is an important contributor to early mortality, accounting for 41% of deaths within the first 30 days after heart transplantation (HT). Donor hypernatremia has been associated with PGF development. However, controversial data exist regarding the impact of sodium deregulation in patient survival after HT. This study aimed to assess the influence of donor hypernatremia on PGF development and to determine the serum sodium level threshold to assist in decision-making for organ procurement.METHODS:
The medical record from 200 HT patients and organ donors were retrospectively assessed and categorized by PGF occurrence. Donor sodium leve were compared and cut-off points obtained by receiver operating characteristic (ROC) curve. A multiple logistic regression model was applied to assess the effects of factors and covariates that influence PGF development.RESULTS:
Sodium levels of donors were significantly higher in recipients who developed PGF than those who did not develop PGF (162 vs. 153 mmol/L, p = 0.001). The sodium cut-off value determined by the ROC curve was 159 mmol/L. The group who received organs from donors with a serum sodium concentration >/=159 mmol/L had a higher incidence of PGF (63.3% vs 32.4%, p < 0.001). Furthermore, donor sodium levels >/=159 mmol/L increased the likelihood of recipients developing PGF by 3.4 times. It is also observed that the incidence of donor smoking addiction was significantly higher in the PGF group (28.6% vs. 11.5%, p = 0.004) and donor smoking addiction increased the risk of developing PGF by 2.8 times.CONCLUSION:
Smoking addiction and the application of suboptimal organs from donors with hypernatremia contribute to primary graft failure in heart transplantation. (AU)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Transplante de Coração
/
Fumantes
/
Hipernatremia
Tipo de estudo:
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Clin. transplant
Ano de publicação:
2019
Tipo de documento:
Artigo
Instituição/País de afiliação:
Department of Cardiothoracic Surgery, Dante Pazzanese Institute of Cardiology/BR
/
Department of Clinical Heart Transplantation, Dante Pazzanese Institute of Cardiology/BR
/
Laboratory of Molecular Investigation in Cardiology, Dante Pazzanese Institute of Cardiology/BR
/
Statistic and Epidemiology Laboratory, Dante Pazzanese Institute of Cardiology/BR