Potassium levels after liver reperfusion in adult patients undergoing cadaveric liver transplantation: A retrospective cohort study
- Authors
- Weinberg, Laurence; Lee, Dong-Kyu; Koshy, Anoop Ninan; Leong, Kai Wen; Tosif, Shervin; Shaylor, Ruth; Pillai, Param; Miles, Lachlan Fraser; Drucker, Alexandra; Pearce, Brett
- Issue Date
- 7월-2020
- Publisher
- ELSEVIER SCI LTD
- Keywords
- Liver transplantation; Potassium; Reperfusion; Anesthesia
- Citation
- ANNALS OF MEDICINE AND SURGERY, v.55, pp.111 - 118
- Indexed
- SCOPUS
- Journal Title
- ANNALS OF MEDICINE AND SURGERY
- Volume
- 55
- Start Page
- 111
- End Page
- 118
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/130596
- DOI
- 10.1016/j.amsu.2020.05.002
- ISSN
- 2049-0801
- Abstract
- Background: Hyperkalemia is a common cause of arrhythmias in patients undergoing liver transplantation. We examined the pattern of change of potassium levels during and immediately after reperfusion of the donor liver. Materials and methods: Potassium levels of 30 consecutive adult patients undergoing cadaveric liver transplantation were assessed before and after liver reperfusion. Changes in potassium levels over 13 predefined time-points were analyzed. Primary aim: to describe the pattern of change of potassium levels during the reperfusion period. Correlation between changes in potassium levels during reperfusion and a-priori variables were investigated. Results: Baseline median (IQR) potassium levels were 4.1 (3.8:4.5) mmol/L. Thirteen patients (43%) developed hyperkalemia, 10 (33%) of whom developed severe hyperkalemia. Potassium levels peaked at 80 s post re-perfusion, plateaued until 2 min, before returning toward baseline values at 5 min. There was a strong association between pre-reperfusion/baseline potassium levels and peak potassium values during reperfusion (95%CI: 0.26 to 0.77, p < 0.001). A baseline potassium level of 4.45 mmol/L was a good predictor of re-perfusion hyperkalemia with a sensitivity of 69.2% and specificity of 94.1% (AUC = 0.894, 95%CI: 0.779 to 1.000, p < 0.001). Conclusion: Hyperkalemia during cadaveric liver transplantation is common affecting almost 1 in 2 patients during reperfusion. During reperfusion potassium levels peaked within 2 min and over a third of patients developed severe hyperkalemia. Higher peak potassium levels correlated strongly with higher pre-reperfusion potassium values. These findings guide clinicians with timing of sampling of blood to check for hyperkalemia and identify modifiable factors associated with the development of hyperkalemia.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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