{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:17:48Z","timestamp":1768868268755,"version":"3.49.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":2314,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2009,5]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>Hyponatremia is associated with reduced survival in patients with cirrhosis awaiting orthotopic liver transplantation (OLT). However, data are sparse regarding the impact of hyponatremia on outcome following OLT. We investigated the effect of hyponatremia at the time of OLT on mortality and morbidity following the procedure. The study included 2,175 primary OLT recipients between 1990 and 2000. Serum sodium concentrations obtained immediately prior to OLT were correlated with subsequent survival using proportional hazards analysis. Morbidity associated with hyponatremia was assessed, including length of hospitalization, length of intensive care unit (ICU) admission, and occurrence of central pontine myelinolysis (CPM). Out of 2,175 subjects, 1,495 (68.7%) had normal serum sodium (&gt;135 mEq\/L) at OLT, whereas mild hyponatremia (125-134 mEq\/L) was present in 615 (28.3%) and severe hyponatremia (&lt;125 mEq\/L) in 65 (3.0%). Serum sodium had no impact on survival up to 90 days after OLT (multivariate hazard ratio = 1.00, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.99). Patients with severe hyponatremia tended to have a longer stay in the ICU (median = 4.5 days) and hospital (17.0 days) compared to normonatremic recipients (median ICU stay = 3.0 days, hospital stay = 14.0 days; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.02 and 0.08, respectively). There were 10 subjects that developed CPM, with an overall incidence of 0.5%. Although infrequent, the incidence of CPM did correlate with serum sodium levels (<jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.01). <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Pre-OLT serum sodium does not have a statistically significant impact on survival following OLT. The incidence of CPM correlates with hyponatremia, although its overall incidence is low. Incorporation of serum sodium in organ allocation may not adversely affect the overall post-OLT outcome. (Hepatology 2009;49:1610\u20131615.)<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.22846","type":"journal-article","created":{"date-parts":[[2009,1,23]],"date-time":"2009-01-23T15:18:08Z","timestamp":1232723888000},"page":"1610-1615","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":112,"title":["Impact of pretransplant hyponatremia on outcome following liver transplantation #"],"prefix":"10.1097","volume":"49","author":[{"given":"Byung Cheol","family":"Yun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ray W.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne T.","family":"Benson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W.","family":"Biggins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry M.","family":"Therneau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter K.","family":"Kremers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles B.","family":"Rosen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran B.","family":"Klintmalm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-24-20241201","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/BF01095898","article-title":"Prognostic value of spontaneous hyponatremia in cirrhosis with ascites.","volume":"21","author":"Arroyo","year":"1976","journal-title":"Am J Dig Dis"},{"key":"R2-24-20241201","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1002\/hep.21412","article-title":"Hyponatremia in cirrhosis: Results of a patient population survey.","volume":"44","author":"Angeli","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R3-24-20241201","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/hep.510280337","article-title":"Hyponatremia in cirrhosis: from pathogenesis to treatment.","volume":"28","author":"Gines","year":"1998","journal-title":"HEPATOLOGY"},{"key":"R4-24-20241201","doi-asserted-by":"crossref","first-page":"413","DOI":"10.7326\/0003-4819-96-4-413","article-title":"Role of vasopressin in abnormal water excretion in cirrhotic patients.","volume":"96","author":"Bichet","year":"1982","journal-title":"Ann Intern Med"},{"key":"R5-24-20241201","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/0016-5085(85)90664-X","article-title":"Derangements of renal water handling in liver disease.","volume":"89","author":"Epstein","year":"1985","journal-title":"Gastroenterology"},{"key":"R6-24-20241201","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1002\/hep.1840080532","article-title":"Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis.","volume":"8","author":"Schrier","year":"1988","journal-title":"HEPATOLOGY"},{"key":"R7-24-20241201","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/0016-5085(88)90441-6","article-title":"Prognostic value of arterial pressure, endogenous vasoactive systems, and renal function in cirrhotic patients admitted to the hospital for the treatment of ascites.","volume":"94","author":"Llach","year":"1988","journal-title":"Gastroenterology"},{"key":"R8-24-20241201","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S0168-8278(00)00011-8","article-title":"A prognostic model for predicting survival in cirrhosis with ascites.","volume":"34","author":"FernandezEsparrach","year":"2001","journal-title":"J Hepatol"},{"key":"R9-24-20241201","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1001\/archinte.162.3.323","article-title":"Dilutional hyponatremia in patients with cirrhosis and ascites.","volume":"162","author":"Porcel","year":"2002","journal-title":"Arch Intern Med"},{"key":"R10-24-20241201","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/S1590-8658(00)80844-0","article-title":"Clinical relevance of hyponatraemia for the hospital outcome of cirrhotic patients.","volume":"32","author":"Borroni","year":"2000","journal-title":"Dig Liver Dis"},{"key":"R11-24-20241201","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/0016-5085(93)90031-7","article-title":"Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites.","volume":"105","author":"Gines","year":"1993","journal-title":"Gastroenterology"},{"key":"R12-24-20241201","first-page":"261","article-title":"New classification with prognostic value in cirrhotic patients.","volume":"15","author":"Cosby","year":"1989","journal-title":"Miner Electrolyte Metab"},{"key":"R13-24-20241201","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/0002-9343(65)90041-0","article-title":"Renal failure in patients with cirrhosis of the liver. I. Clinical and pathologic characteristics.","volume":"39","author":"Shear","year":"1965","journal-title":"Am J Med"},{"key":"R14-24-20241201","doi-asserted-by":"crossref","first-page":"1652","DOI":"10.1053\/j.gastro.2006.02.010","article-title":"Evidencebased incorporation of serum sodium concentration into MELD.","volume":"130","author":"Biggins","year":"2006","journal-title":"Gastroenterology"},{"key":"R15-24-20241201","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1053\/jhep.2001.22172","article-title":"A model to predict survival in patients with endstage liver disease.","volume":"33","author":"Kamath","year":"2001","journal-title":"HEPATOLOGY"},{"key":"R16-24-20241201","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1053\/gast.2003.50016","article-title":"Model for endstage liver disease (MELD) and allocation of donor livers.","volume":"124","author":"Wiesner","year":"2003","journal-title":"Gastroenterology"},{"key":"R17-24-20241201","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1002\/hep.1840400409","article-title":"Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death.","volume":"40","author":"Heuman","year":"2004","journal-title":"HEPATOLOGY"},{"key":"R18-24-20241201","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/hep.20517","article-title":"Serum sodium predicts mortality in patients listed for liver transplantation.","volume":"41","author":"Biggins","year":"2005","journal-title":"HEPATOLOGY"},{"key":"R19-24-20241201","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1002\/lt.20329","article-title":"Addition of serum sodium into the MELD score predicts waiting list mortality better than MELD alone.","volume":"11","author":"Ruf","year":"2005","journal-title":"Liver Transpl"},{"key":"R20-24-20241201","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1002\/lt.21154","article-title":"The impact of serum sodium concentration on mortality after liver transplantation: a cohort multicenter study.","volume":"13","author":"Dawwas","year":"2007","journal-title":"Liver Transpl"},{"key":"R21-24-20241201","first-page":"1048","article-title":"The possible causes of central pontine myelinolysis after liver transplantation.","volume":"42","author":"Yu","year":"2004","journal-title":"in Chinese Zhonghua Wai Ke Za Zhi"},{"key":"R22-24-20241201","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1053\/j.gastro.2006.02.017","article-title":"Hyponatremia impairs early posttransplantation outcome in patients with cirrhosis undergoing liver transplantation.","volume":"130","author":"Londono","year":"2006","journal-title":"Gastroenterology"},{"key":"R23-24-20241201","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1399-0012.1998.tb01102.x","article-title":"Liver transplantation in hyponatremic patients with emphasis on central pontine myelinolysis.","volume":"12","author":"Abbasoglu","year":"1998","journal-title":"Clin Transplant"},{"key":"R24-24-20241201","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1056\/NEJM200005253422107","article-title":"Hyponatremia.","volume":"342","author":"Adrogue","year":"2000","journal-title":"N Engl J Med"},{"key":"R25-24-20241201","doi-asserted-by":"crossref","first-page":"248","DOI":"10.5414\/CNP65248","article-title":"Acute and concomitant deterioration of hyponatremia and renal dysfunction associated with heart and liver failure.","volume":"65","author":"Hoorn","year":"2006","journal-title":"Clin Nephrol"},{"key":"R26-24-20241201","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/0168-8278(88)80020-5","article-title":"Liver transplantation in patients with nonbiliary cirrhosis: prognostic value of preoperative factors.","volume":"28","author":"Gonzalez","year":"1998","journal-title":"J Hepatol"},{"key":"R27-24-20241201","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1002\/lt.20137","article-title":"Survival after liver transplantation in the United States: a diseasespecific analysis of the UNOS database.","volume":"10","author":"Roberts","year":"2004","journal-title":"Liver Transpl"},{"key":"R28-24-20241201","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1002\/hep.21414","article-title":"Aquaporin1 and aquaporin2 urinary excretion in cirrhosis: relationship with ascites and hepatorenal syndrome.","volume":"44","author":"EstevaFont","year":"2006","journal-title":"HEPATOLOGY"},{"key":"R29-24-20241201","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1097\/01.TP.0000101009.91516.FC","article-title":"Predicting outcome after liver transplantation: utility of the model for endstage liver disease and a newly derived discrimination function.","volume":"77","author":"Desai","year":"2004","journal-title":"Transplantation"},{"key":"R30-24-20241201","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1002\/lt.20764","article-title":"Development and validation of a model predicting graft survival after liver transplantation.","volume":"12","author":"Ioannou","year":"2006","journal-title":"Liver Transpl"},{"key":"R31-24-20241201","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1097\/00007890-198912000-00023","article-title":"Pontine and extrapontine myelinolysis following liver transplantation. Relationship to serum sodium.","volume":"48","author":"Wszolek","year":"1989","journal-title":"Transplantation"},{"key":"R32-24-20241201","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1212\/WNL.44.7.1226","article-title":"Predictive factors of inhospital CNS complications following liver transplantation.","volume":"44","author":"Pujol","year":"1994","journal-title":"Neurology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.22846","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200905000-00024","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T13:44:03Z","timestamp":1733060643000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200905000-00024"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.22846","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2009,5]]}}}