Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation

Ferah, Oya; Akdeniz, Cansu; Tokat, Yaman; Canbolat, Ismail Polat

doi:10.5543/tkda.2020.42637

Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation

İsmail Polat CANBOLAT, (Demiroğlu Bilim Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Cansu AKDENİZ, (Demiroğlu Bilim Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul, Türkiye)

Oya FERAH, (Demiroğlu Bilim Üniversitesi, Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye)

Yaman TOKAT (Şişli Florence Nightingale Hastanesi, Karaciğer Nakli Merkezi, İstanbul, Türkiye)

Türk Kardiyoloji Derneği Arşivi

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Yıl: 2020 Cilt: 48 Sayı: 4 Sayfa Aralığı: 374 - 379 Metin Dili: İngilizce DOI: 10.5543/tkda.2020.42637 İndeks Tarihi: 26-11-2020

Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation

Öz:

Objective: The post-operative serum level of N-terminalpro-brain natriuretic peptide (NT-proBNP) has been foundto be associated with post-operative cardiovascular complications and mortality in high-risk surgeries. The usefulnessof the post-operative NT-proBNP level as a predictor of mortality after liver transplantation (LT) is unknown.Methods: The records of patients at a single, tertiary university hospital who had undergone adult living donor livertransplantation (LDLT) with data of post-operative NTproBNP level values were retrospectively analyzed for in--hospital mortality. The highest post-operative NT-proBNPlevel from the first 3 days after surgery was included in thestudy. Receiver operating characteristic curve analysis wasperformed to assess the best cut-off value of post-operativeNT-proBNP, and Cox regression analysis was performed toinvestigate the effect of NT-proBNP on mortality.Results: A total of 114 LT recipients with a mean Modelfor End-Stage Liver Disease score of 15.8 were includedin the study. In-hospital mortality occurred in 11 (9.6%) ofthe patients. A history of diabetes mellitus and the post-operative NT-proBNP level were found to be associated withmortality (p=0.011 for diabetes mellitus and p<0.001 forNT-proBNP). The best cut-off value of post-operative NTproBNP was 1009 ng/L. Cox regression analysis indicatedthat the NT-proBNP level was a strong predictor of in-hospital mortality (hazard ratio: 24.467, 95% confidence interval:3.120–191.750; p=0.002).Conclusion: The post-operative NT-proBNP serum level independently predicted in-hospital mortality in patients whounderwent LDLT. Post-operative NT-proBNP-guided management of LT recipients should be pursued.

Anahtar Kelime:

Canlı vericili karaciğer nakli cerrahisi sonrası N-terminal pro-beyin natriüretik peptit düzeyleri hastane içi mortaliteyi öngördürmektedir

Öz:

Amaç: Yüksek riskli cerrahilerde operasyon sonrası bakılan N-terminal pro-beyin natriüretik peptit (NT-proBNP) serum düzeyleri kardiyovasküler komplikasyonları ve mortaliteyi öngördürücü olarak saptanmıştır. Karaciğer nakli sonrası bakılan NT-proBNP serum düzeyleri ile mortalite arasındaki ilişki henüz bilinmemektedir. Yöntemler: Tek merkezli bu çalışmada, ameliyat sonrası NT-proBNP değerine sahip canlı vericili karaciğer nakli uygulanan hastalar hastane içi mortalite açısından retrospektif olarak incelendi. Operasyon sonrası ilk 72 saatte, günlük olarak bakılan nt-proBNP değerlerinden en yüksek değer analize alındı. Postoperatif nt-proBNP’ye ait en iyi kestirim değerini belirlemek için ROC eğrisi analizi yapıldı ve ameliyat sonrası NT-proBNP’nin bağımsız öngördürücülüğünü değerlendirmek için Cox regresyon analizi uygulandı. Bulgular: Karaciğer nakli uygulanmış, ortalama MELD skoru 15.8 olan 114 hasta çalışmaya dahil edildi. Hastane içi mortalite 11 (9.6%) hastada gerçekleşti. Diabetes mellitus ve postoperatif NT-proBNP değerleri hastane içi mortalite ile istatistiksel olarak anlamlı idi (diabetes mellitus için p=0.011 ve NT-proBNP için p<0.001). Ameliyat sonrası NTproBNP için en iyi kestirim değeri 1009 ng/L idi. Cox regresyon analizinde NT-proBNP hastane içi mortalitenin kuvvetli bir öngördürücüsü olarak saptandı [HR (95% CI): 24.467, (3.120–191.750), p=0.002]. Sonuç: Canlı vericili karaciğer nakli uygulanan hastalarda, ameliyat sonrası NT-proBNP hastane içi mortalitenin bağımsız bir öngördürücüsüdür. Ameliyat sonrası NT-proBNP kılavuzluğunda karaciğer nakli alıcısının yönetimi açısından çalışmalar gerekmektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Canbolat I, Akdeniz C, Ferah O, Tokat Y (2020). Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. , 374 - 379. 10.5543/tkda.2020.42637
Chicago	Canbolat Ismail Polat,Akdeniz Cansu,Ferah Oya,Tokat Yaman Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. (2020): 374 - 379. 10.5543/tkda.2020.42637
MLA	Canbolat Ismail Polat,Akdeniz Cansu,Ferah Oya,Tokat Yaman Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. , 2020, ss.374 - 379. 10.5543/tkda.2020.42637
AMA	Canbolat I,Akdeniz C,Ferah O,Tokat Y Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. . 2020; 374 - 379. 10.5543/tkda.2020.42637
Vancouver	Canbolat I,Akdeniz C,Ferah O,Tokat Y Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. . 2020; 374 - 379. 10.5543/tkda.2020.42637
IEEE	Canbolat I,Akdeniz C,Ferah O,Tokat Y "Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation." , ss.374 - 379, 2020. 10.5543/tkda.2020.42637
ISNAD	Canbolat, Ismail Polat vd. "Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation". (2020), 374-379. https://doi.org/10.5543/tkda.2020.42637

APA	Canbolat I, Akdeniz C, Ferah O, Tokat Y (2020). Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Türk Kardiyoloji Derneği Arşivi, 48(4), 374 - 379. 10.5543/tkda.2020.42637
Chicago	Canbolat Ismail Polat,Akdeniz Cansu,Ferah Oya,Tokat Yaman Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Türk Kardiyoloji Derneği Arşivi 48, no.4 (2020): 374 - 379. 10.5543/tkda.2020.42637
MLA	Canbolat Ismail Polat,Akdeniz Cansu,Ferah Oya,Tokat Yaman Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Türk Kardiyoloji Derneği Arşivi, vol.48, no.4, 2020, ss.374 - 379. 10.5543/tkda.2020.42637
AMA	Canbolat I,Akdeniz C,Ferah O,Tokat Y Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Türk Kardiyoloji Derneği Arşivi. 2020; 48(4): 374 - 379. 10.5543/tkda.2020.42637
Vancouver	Canbolat I,Akdeniz C,Ferah O,Tokat Y Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Türk Kardiyoloji Derneği Arşivi. 2020; 48(4): 374 - 379. 10.5543/tkda.2020.42637
IEEE	Canbolat I,Akdeniz C,Ferah O,Tokat Y "Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation." Türk Kardiyoloji Derneği Arşivi, 48, ss.374 - 379, 2020. 10.5543/tkda.2020.42637
ISNAD	Canbolat, Ismail Polat vd. "Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation". Türk Kardiyoloji Derneği Arşivi 48/4 (2020), 374-379. https://doi.org/10.5543/tkda.2020.42637