title: [A case of severe acute hyperkalemia during pre-anhepatic stage in living-related liver transplantation].
abstract: We reported a case of severe acute hyperkalemia during pre-anhepatic stage in living-related liver transplantation. The serum potassium concentration was elevated from 5.1 mmol.l-1 to 7.3 mmol.l-1 after hepatic artery ligation. Inspite of administration of diuretics, calcium and glucose-insulin, T wave on ECG was elevated and premature ventricular contractions occurred frequently. Finally, ventricular tachycardia occurred three times. After hepatic vein ligation, in anhepatic stage, serum potassium decreased gradually to 3.7 mmol.l-1 and arrhythmia disappeared. We consider that the main cause of hyperkalemia in this case is flowing out of potassium from the ischemic liver by surgical manipulation. It is necessary to take care of the change of serum potassium concentration not only in postreperfusion but also pre-anhepatic stage in living-related liver transplantation.
authors.affiliation: Department of Anesthesiology and Resuscitology, School of Medicine, Okayama University, Okayama 700-8558.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kaku
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsumi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Fujii
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ohashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizobuchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Katayama
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
authors.forename: Masahisa
authors.initials: M
authors.lastname: Hirakawa
mesh_terms: D000208:Acute Disease; D000758:Anesthesia; D006801:Humans; D006947:Hyperkalemia / Q000209:etiology* / Q000628:therapy; D007431:Intraoperative Complications / Q000209:etiology* / Q000628:therapy; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D015424:Reperfusion / Q000009:adverse effects; D012720:Severity of Illness Index; D017180:Tachycardia, Ventricular / Q000209:etiology