[A case of severe acute hyperkalemia during pre-anhepatic stage in living-related liver transplantation].
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.
Kaku
Ryuji
R
Department of Anesthesiology and Resuscitology, School of Medicine, Okayama University, Okayama 700-8558.
Matsumi
Masaki
M
Fujii
Hiromi
H
Ohashi
Ichiro
I
Mizobuchi
Satoshi
S
Katayama
Hiroshi
H
Morita
Kiyoshi
K
Hirakawa
Masahisa
M
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