Archives of the Turkish Society of Cardiology
Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2020; 48(4): 374-379 | 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 Canbolat1, Cansu Akdeniz1, Oya Ferah2, Yaman Tokat3
1Department of Cardiology, Demiroğlu Bilim University Faculty of Medicine, İstanbul, Turkey
2Department of Anesthesiology and Reanimation, Demiroğlu Bilim University Faculty of Medicine, İstanbul, Turkey
3Center of Liver Transplantation, Şişli Florence Nightingale Hospital, İstanbul, Turkey


OBJECTIVE
The post-operative serum level of N-terminal pro-brain natriuretic peptide (NT-proBNP) has been found to be associated with post-operative cardiovascular complications and mortality in high-risk surgeries. The usefulness of 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 liver transplantation (LDLT) with data of post-operative NT-proBNP level values were retrospectively analyzed for in-hospital mortality. The highest post-operative NT-proBNP level from the first 3 days after surgery was included in the study. Receiver operating characteristic curve analysis was performed to assess the best cut-off value of post-operative NT-proBNP, and Cox regression analysis was performed to investigate the effect of NT-proBNP on mortality.

RESULTS
A total of 114 LT recipients with a mean Model for End-Stage Liver Disease score of 15.8 were included in the study. In-hospital mortality occurred in 11 (9.6%) of the patients. A history of diabetes mellitus and the post-operative NT-proBNP level 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 post-operative NT-proBNP was 1009 ng/L. Cox regression analysis indicated that 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 who underwent LDLT. Post-operative NT-proBNP-guided management of LT recipients should be pursued.

Keywords: In-hospital mortality, Living donor liver transplantation; NT-proBNP.

How to cite this article
İsmail Polat Canbolat, Cansu Akdeniz, Oya Ferah, Yaman Tokat. Post-operative N-terminal pro-brain natriuretic peptide predicts in-hospital mortality after living donor liver transplantation. Turk Kardiyol Dern Ars. 2020; 48(4): 374-379

Corresponding Author: İsmail Polat Canbolat, Türkiye
© Copyright 2020 Archives of the Turkish Society of Cardiology
LookUs & Online Makale