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24 November 2014 : Original article  

Acquired Hyponatremia in Pediatric Living Donor Liver Transplantation

Sheng-Chun YangABCDEF, Chih-Hsien WangABC, Chao-Long ChenAB, Kwok-Wai ChengABC, Shao-Chun WuABCD, Tsung-Hsiao ShihABC, Bruno JawanABCDEF, Chia-Jung HuangABCDEF

DOI: 10.12659/AOT.892191

Ann Transplant 2014; 19:609-613

Abstract

BACKGROUND: The aim of this study was to evaluate the incidence of acquired hyponatremia (AH) in our pediatric living donor liver transplantation (LDLT) patients, and to identify the potential predictive risk factors of the causes of AH.

MATERIAL AND METHODS: The 189 pediatric LDLT patients were divided into 2 groups: serum sodium level at the end of the surgery lower than 130 mEq/L in GI (n=16) and higher than 130 mEq/L in GII (n=173). Patients’ data were analyzed by Mann-Whitney U test, univariate analysis, and multiple binary logistic regression model. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the logistic model formulated. P value <0.05 was regarded as statistically significant.

RESULTS: In the multiple binary logistic regression model, the hypotonic solution administration rate (ml/kg/h) was the only independent predictor of AH with a p<0.017. Receiver operating curve (ROC) analysis indicated that giving more than 3.5 ml/kg/h hypotonic solution infusion may cause AH. Preoperative hyponatremia did not increase the incidence of acquired hyponatremia.

CONCLUSIONS: Increasing the administration of hypotonic solution by 1 ml/kg/h in pediatric LDLT would increase the risk of developing AH by 1.272 times. The critical administration rate of hypotonic solution was 3.5 ml/kg/h.

Keywords: Anesthesia, Hyponatremia, Liver Transplantation, Living Donors, Pediatrics

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358