Hiponatremia dilucional y trasplante hepático. Revisión A Review of Dilutional Hyponatremia and Liver Transplantation

Patients with advanced liver disease may present volume overloads that can lead to the development of dilutional hyponatremia primarily as the result of persistently high levels of antidiuretic hormone. Liver trans- plantation is the therapy of choice for patients with terminal liver disease. Patient survival time following trans- plantation is excellent. Dilutional hyponatremia has proven to be a prognostic factor for patients with cirrhosis, and it can even lead to mortality in patients on the waiting list for liver transplantation. Consequently, it is currently part of the scoring system for classifying patients with advanced liver disease who are on the waiting list for liver transplantation. The role of pretransplant hyponatremia in the prognoses of patients scheduled for liver transplantation is the subject of renewed interest, but the data in the literature is rather contradictory. Until recently, the only treatment for dilutional hyponatremia was the restriction of water intake, but now new and encouraging treatments are available that are directed against dilutional hyponatremia in patients with cirrhosis. Nevertheless, little is known about their effects in patients with cirrhosis who are about to undergo liver transplantation.