Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23479
Title: Potassium levels after liver reperfusion in adult patients undergoing cadaveric liver transplantation: A retrospective cohort study.
Authors: Weinberg, Laurence;Lee, Dong-Kyu;Koshy, Anoop N;Leong, Kai Wen;Tosif, Shervin;Shaylor, Ruth;Pillai, Parameswan;Miles, Lachlan F;Drucker, Alexandra;Pearce, Brett
Affiliation: Department of Surgery, Austin Health, University of Melbourne, Victoria, Australia
Department of Anesthesiology and Pain Medicine, Korea University, Guro Hospital, Guro-Gu, Seoul, Republic of Korea..
Department of Cardiology, Austin Health, Victoria, Australia
Austin Health, Victoria, Australia
Department of Anesthesia, Austin Health, Victoria, Australia
Intensive Care Unit, Austin Health, Victoria, Australia
Issue Date: Jul-2020
EDate: 2020
Citation: Annals of medicine and surgery (2012) 2020; 55: 111-118
Abstract: 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. 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 timepoints 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. 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 reperfusion, 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 reperfusion 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). 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.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23479
DOI: 10.1016/j.amsu.2020.05.002
ORCID: 0000-0001-7403-7680
0000-0002-8741-8631
0000-0003-2044-5560
PubMed URL: 32477508
ISSN: 2049-0801
Type: Journal Article
Subjects: Anesthesia
Liver transplantation
Potassium
Reperfusion
Appears in Collections:Journal articles

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