Cardiac arrest after graft reperfusion during liver transplantation.
BACKGROUND
Cardiac arrest (CA) during orthotopic liver transplantation (OLT) is rare but it threatens the lives of patients. The cause of perioperitive CA is not fully understood. We reported the occurrence of CA in 5 patients after unclamping of the vena cava and investigated the relationship between CA and associated variables.


METHODS
Five patients with CA after graft reperfusion during OLT in our unit from November 1996 to September 2003 were retrospectively reviewed. Analyzed data included donor and recipient demographic data, and recipient operative and postoperative events.


RESULTS
Five (2.1%) of 240 patients undergoing OLT experienced CA 5 minutes after graft reperfusion. Two patients died of resuscitation failure. Hyperkalemia and metabolic acidosis after revascularization were observed in some patients. The five patients had hypothermia and hypocalcemia, and one had pulmonary embolism.


CONCLUSIONS
CA is one of the syndromes after reperfusion. Many factors such as hyperkalemia, acidosis or pulmonary embolism combined with hypothermia and hypocalcemia during the operation seem to contribute to the occurrence of CA.
Shi
Xue-Yin
XY
Department of Anesthesiology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. btxzd123@126.com
Xu
Zhen-Dong
ZD
Xu
Hai-Tao
HT
Jiang
Jin-Jin
JJ
Liu
Gang
G
D001784:Blood Gas Analysis; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015424:Reperfusion / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D015996:Survival Rate; D014184:Transplantation, Homologous; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000175:diagnosis