Impact of donor sodium levels on clinical outcomes in liver transplant recipients: a systematic review
Bibliographic record
Abstract
We performed a systematic review of the literature to examine the effects of donor sodium levels on liver graft function and recipient survival, as well as to identify the optimal serum sodium target in donors. We searched MEDLINE, Cochrane, and trial registries from 1946 to May 2019 for studies that evaluated the effect of serum sodium levels in neurologically deceased liver donors on transplant outcomes. We used a two-step review process with four independent reviewers to identify relevant articles based on inclusion/exclusion criteria. We summarize the results narratively, assess the risk of bias, and apply the Grading of Recommendations Assessment, Development, and Evaluation methods to evaluate the certainty in the evidence. We included 25 cohort studies were in our final analysis (total n = 19 389). Twenty-two reported on graft function and survival. Summary data suggest an association between donor serum sodium and recipient liver graft dysfunction, with very low certainty in evidence due to serious concerns with risk of bias, inconsistency, indirectness, and imprecision. Seven studies reported on recipient mortality, with results suggesting no association between donor sodium and recipient survival. The certainty in evidence for this outcome was also very low due to serious concerns with imprecision, indirectness, and risk of bias. Donor sodium dysregulation is associated with liver graft dysfunction, but not recipient mortality. Further research is needed to determine the effects of correcting donor sodium levels on transplant outcomes, quantify the dose-response curve, and identify liver recipients most vulnerable to sodium dysregulation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.068 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.010 |
| Bibliometrics | 0.011 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".