Strong ion gap in brain dead patients and its role in predicting outcome in liver transplantation

Liver transplantation is the treatment of choice in end stage liver disease. Marginal graft is a criteria for selecting appropriate liver in many centers. Many studies indicated that SIG is a good predictor for outcome. Our primary objective was to find a correlation between SIG and graft function. Secondary objective was comparison between SIG and marginal graft criteria.

This study was performed in 61 liver recipients. All recipients were selected for transplantation by marginal graft criteria. Strong ion was measured and according to ionized portion SIG was calculated. According to cut of point of SIG=10 and marginal graft criteria, patients were divided into two groups and then compared with each other.

This study was conducted on 61 liver recipients. 39 (63.9%) of them developed with transplantation complication. Only 3(4.9%) presented with PNF and 1 (1.6%) presented with DNF. Mean SIG was 18.41±1.71. 49.2% of livers was marginal. 68% of donors had SIG>10 and 32% had SIG> 10. No difference was seen in these two groups according to liver transplantation complication. (Pvalue: 0.286) In group SIG>10 mean AST was 297±730 and mean ALT was 292±438 and in group SIG<10 mean AST and ALT was 350±566 and 383±440 respectively. This difference is clinically significant. No difference was seen in marginal and non-marginal graft according to liver transplantation complication. (Pvalue:0.245)

SIG in donor is not an appropriate predictor for liver transplantation outcome.