{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T05:12:25Z","timestamp":1773465145545,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,9,8]],"date-time":"2019-09-08T00:00:00Z","timestamp":1567900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Primary graft failure (PGF) is an important contributor to early mortality, accounting for 41% of deaths within the first 30\u00a0days 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\u2010making for organ procurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical record from 200 HT patients and organ donors were retrospectively assessed and categorized by PGF occurrence. Donor sodium levels were compared and cut\u2010off 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sodium levels of donors were significantly higher in recipients who developed PGF than those who did not develop PGF (162 vs. 153\u00a0mmol\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001). The sodium cut\u2010off value determined by the ROC curve was 159\u00a0mmol\/L. The group who received organs from donors with a serum sodium concentration \u2265159\u00a0mmol\/L had a higher incidence of PGF (63.3% vs 32.4%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Furthermore, donor sodium levels \u2265159\u00a0mmol\/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%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) and donor smoking addiction increased the risk of developing PGF by 2.8 times.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Smoking addiction and the application of suboptimal organs from donors with hypernatremia contribute to primary graft failure in heart transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13693","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T14:43:57Z","timestamp":1565621037000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Donor hypernatremia and smoking addiction contribute to primary graft failure in heart transplantation"],"prefix":"10.1111","volume":"33","author":[{"given":"Marco Aur\u00e9lio","family":"Finger","sequence":"first","affiliation":[{"name":"Department of Clinical Heart Transplantation Dante Pazzanese Institute of Cardiology S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reginaldo","family":"Cipullo","sequence":"additional","affiliation":[{"name":"Department of Clinical Heart Transplantation Dante Pazzanese Institute of Cardiology S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5959-9359","authenticated-orcid":false,"given":"Jo\u00e3o Manoel","family":"Rossi Neto","sequence":"additional","affiliation":[{"name":"Department of Clinical Heart Transplantation Dante Pazzanese Institute of Cardiology S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Casadei","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Clinical Heart Transplantation Dante Pazzanese Institute of 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