Donor hypo- and hypernatremia are predictors for increased 1-year mortality after cardiac transplantation

Area of Science:

• Cardiology
• Transplantation immunology
• Nephrology

Background:

• Donor hypernatremia is linked to graft dysfunction in liver transplants.
• The effect of donor sodium dysregulation on heart transplant survival is unclear.
• Electrolyte balance in donors is critical for graft viability.

Purpose of the Study:

• To determine the impact of donor serum sodium levels on long-term survival in heart transplant recipients.
• To analyze donor sodium levels as a predictor of 1-year post-transplant mortality.
• To investigate the relationship between donor hyponatremia/hypernatremia and heart transplant outcomes.

Main Methods:

• Retrospective analysis of 4641 adult heart transplant recipients from the Eurotransplant registry (1997-2005).
• Multivariate analysis to identify predictors of 1-year post-transplant survival.
• Inclusion of donor sodium levels, donor/recipient demographics, and transplant characteristics in the analysis.

Main Results:

• Donors with serum sodium <130 mmol/l or >170 mmol/l were associated with a 1.25-fold increased risk of 1-year mortality (P=0.007).
• Both hyponatremia and hypernatremia demonstrated a U-shaped correlation with poor 1-year survival.
• Recipient age, transplant indication, and urgency status were also independent risk factors for mortality.

Conclusions:

• Donor serum sodium levels outside the normal range are a significant predictor of poor outcomes after heart transplantation.
• Maintaining normal donor sodium levels is crucial for optimizing donor heart quality and recipient survival.
• This study underscores the importance of donor electrolyte management in heart transplantation.