Perioperative terlipressin infusion in living donor liver transplantation: effects on sodium and water balance

Abstract

Background Although terlipressin is being used perioperatively in recipients of liver transplantation to improve splanchnic hemodynamics and postoperative renal functions, its associated antidiuretic effect has not been specifically investigated in this group of patients. The aim of this study is to assess the effect of terlipressin infusion started intraoperatively and continued for 48 h postoperatively in recipients of living donor liver transplantation on serum sodium and water/sodium excretion. Materials and methods Thirty patients with end-stage liver disease and portal hypertension scheduled for living donor liver transplantation were randomized into two groups including 15 patients each. Group 1 (control): patients did not receive terlipressin. Group 2: terlipressin was administered as an infusion at a rate of 2 µg/kg/h continued for 48 h after postoperative ICU admission. Comparisons were performed between both groups in terms of serum sodium, urine sodium, urine osmolarity, and the urine : sodium osmolarity ratio. Results There were no significant changes between the control group and the terlipressin group in serum sodium, urine sodium, urine osmolarity, and the urine : sodium osmolarity ratio. Conclusion Terlipressin infusion started intraoperatively at a rate of 2 µg/kg/h and continued for 48 h postoperatively in recipients of living donor liver transplantation did not result in significant changes in serum sodium and sodium/water excretion.