A Systematic Review of Donor Serum Sodium Level and Its Impact on Transplant Recipients.Basmaji, J., et al.
International Journal of Organ Transplantation Medicine 2020; 11(2): 43-54.
This study aimed to investigate the effects of donor serum sodium levels on kidney, pancreas, lung and heart graft function and recipient mortality, and also to determine the optimum target for donor serum sodium levels.
Searches were performed on MEDLINE and Cochrane up to May 2019. Clinical practice guidelines and trial registry records were also searched to find potentially relevant studies. Study selection and data extraction were conducted by two independent reviewers. The risk of bias was evaluated using the Newcastle Ottawa Scale (NOS).
18 studies were included in the review.
The outcomes of interest were clinical status during the period between declaration of death and organ recovery, organ recovery/acceptance/transplantation, graft survival, graft function, and recipient survival and quality of life.
This systematic review appraised studies associating deceased donor sodium dysregulation with outcomes following non-hepatic transplantation. The authors found very heterogeneous and generally poor-quality evidence, precluding the use of meta-analysis and therefore performing a narrative review. Overall, the evidence-base for regarding donors with sodium dysregulation as marginal is poor, and therefore non-hepatic organ utilization decisions based upon donor sodium levels are not justified by existing evidence. The review methodology is good, with comprehensive searches and screening and good assessment of bias in the individual studies. Perhaps the only flaw is the lack of a published review protocol prior to the review commencing.