Turk Kardiyol Dern Ars. Ahead of Print: TKDA-42637 | DOI: 10.5543/tkda.2020.42637
Postoperative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation
İsmail Polat Canbolat1
, Cansu Akdeniz1
, Oya Ferah2
, Yaman Tokat31
Department of Cardiology, Demiroğlu Bilim University, İstanbul, Turkey2
Department of Anesthesiology and Reanimation, Demiroğlu Bilim University, İstanbul, Turkey3
Center of Liver Transplantation, Şişli Florence Nightingale Hospital, İstanbul, Turkey
OBJECTIVE Postoperative N-terminal pro brain natriuretic peptid (nt-proBNP) serum levels have been found to be associated with postoperative cardiovascular complications and mortality in high risk surgeries. The usefulness of postoperative nt-proBNP levels as a predictor of mortality after liver transplantation is unknown.
METHODS Patients who had undergone adult living donor liver transplantation (LDLT) with postoperative nt-proBNP levels in a single tertiary university hospital were retrospectively analyzed for in-hospital mortality. Postoperative nt-proBNP levels were collected for the first 3 days after surgery and the highest level was included in the study. Receiver operating characteristic curve analysis was performed to assess the best cut-off value of postoperative nt-proBNP and Cox regression analysis was performed to investigate the effect of nt-proBNP on mortality.
RESULTS A total of 114 liver transplant recipients with a mean MELD score of 15.8 were included in the study. In-hospital mortality occurred in 11 (9.6%) of the patients.History of diabetes mellitus and postoperative nt-proBNP levels were found to be associated with mortality (p=0.011 for diabetes mellitus and p<0.001 for nt-proBNP). The best cut-off value of postoperative nt-proBNP was 1009 ng/L and on Cox regression analysis, nt-proBNP level was a strong predictor of in-hospital mortality [HR (95% CI): 24.467, (3.120, 191.750), p=0.002].
CONCLUSION In patients undergoing LDLT, postoperative nt-proBNP serum level independently predicts in-hospital mortality. Postoperative nt-proBNP guided management of liver transplant recipients should be sought.
living donor liver transplantation, nt-proBNP, in-hospital mortality
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Corresponding Author: İsmail Polat Canbolat, Türkiye