Ascites and Serum Sodium Are Markers of Increased Waiting List Mortality in Children With Chronic Liver Failure

• DOI: 10.1002/hep.26776
• Publication Date: 2013-10-12T02:11:04Z
• Authors: Renata Pugliese; Eduardo A. Fonseca; Gilda Porta; Vera Danesi; Teresa Guimaraes; Adriana Porta; Irene K. Miura; Cristian Borges; Helry Candido; Marcel Benavides; Flavia H. Feier; Andre Godoy; Rita Antonelli Ca...; Mario Kondo; Paulo Chapchap; Joao Seda Neto
• Keywords: Male; Adolescent; Waiting Lists; Sodium; Ascites; Infant; Liver Transplantation; 3. Good health; End Stage Liver Disease; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Living Donors; Humans; Female; Child; Biomarkers; Proportional Hazards Models; Retrospective Studies

Ascites is the most common complication of cirrhosis and in adults it associated with 50% mortality at 5 years if patients do not receive a liver transplant. The occurrence hyponatremia these has been increased on waiting list. importance serum sodium levels presence ascites pediatric setting remain to be clarified. A retrospective analysis transplant list was carried out between October 2000 February 2012. primary objective this study evaluate association pretransplant variables within 90 days following inclusion In all, 522 were included study; 345 (66%) under 1 year age; 208 (40%) children presented ascites. multivariate Cox proportional hazards conducted total bilirubin ( P < 0.001, hazard ratio [HR] = 2.09, 95% confidence interval [CI] 1.35-3.21), international normalized (INR) HR 9.83, CI 4.51-21.45), 0.03, 0.96, 0.92-0.99), 2.59, 1.44-4.64), categorized age (0-1 versus ≥1 old) 0.025, 2.33, 1.11-4.86) independently risk death days. Malnutrition (Z score height/age, weight/age) albumin (pediatric endstage disease [PELD] formula) final model. Conclusion : are important decreased patient survival while candidates wait for graft. Multicenter studies necessary validate findings order improve current allocation policies based PELD score. (Hepatology 2014;59:1964–1971)