Kim Jeayoun, Kwon Ji-Hye, Kim Gaab Soo
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
Diagnostics (Basel). 2021 Nov 30;11(12):2248. doi: 10.3390/diagnostics11122248.
The incidence of hyperkalemia (>5.5 mEq/L) or high blood potassium (5-5.5 mEq/L) during living-donor liver transplantation (LDLT) is reported to be more than 10%. It occurs more frequently in the early post-reperfusion period and is a major cause of post-reperfusion arrhythmia and cardiac arrest. Unlike deceased-donor liver transplantation, the pattern of blood potassium changes immediately after reperfusion has not been described in LDLT. From January 2021 to March 2021, fifteen consecutive patients were enrolled. Baseline blood potassium was measured from blood samples obtained 10-min (T) and immediately before (T) reperfusion. During the first 5 min after reperfusion, blood potassium measurements were conducted every one minute (T-T). The blood potassium levels at T and T were 3.8 ± 0.4 and 3.9 ± 0.4 mEq/L, respectively. After reperfusion, mean increases (95% CI) in blood potassium from T and T were 0.5 (0.4-0.6) and 0.4 (0.3-0.5) mEq/L, respectively. Blood potassium peaked at T, returned to baseline at T, and fell below the baseline at T. Peak blood potassium after reperfusion showed strong correlations with blood potassium measured at T ( < 0.001) and T ( < 0.0001). These findings can support the establishment of future research plans and perioperative management of blood potassium in LDLT.
据报道，活体肝移植（LDLT）期间高钾血症（>5.5 mEq/L）或高血钾（5 - 5.5 mEq/L）的发生率超过10%。它在再灌注后早期更频繁发生，是再灌注后心律失常和心脏骤停的主要原因。与尸体供肝肝移植不同，LDLT中再灌注后即刻血钾变化模式尚未见描述。从2021年1月至2021年3月，连续纳入15例患者。在再灌注前10分钟（T₀）和即将再灌注前（T₁）采集血样测量基线血钾。再灌注后的前5分钟内，每分钟（T₂ - T₆）进行血钾测量。T₀和T₁时的血钾水平分别为3.8±0.4和3.9±0.4 mEq/L。再灌注后，与T₀和T₁相比，血钾的平均升高（95%CI）分别为0.5（0.4 - 0.6）和0.4（0.3 - 0.5）mEq/L。血钾在T₃达到峰值，在T₄恢复到基线，并在T₅降至基线以下。再灌注后的血钾峰值与T₀（<0.001）和T₁（<0.0001）时测量的血钾呈强相关。这些发现可为未来LDLT血钾研究计划的制定和围手术期血钾管理提供支持。
