Standard eﬄuent potassium concentration as a predictive factor for postreperfusion signiﬁcant arrhythmias in deceased liver transplantation
1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China
2Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China
Submitted: 01 May 2021 Accepted: 31 May 2021
Online publish date: 08 July 2021
Objectives: Postreperfusion significant arrhythmias (PRSA), which is known as part of the diagnostic criteria for postreperfusion syndrome, may serve as a precursor of postreperfusion cardiac arrest (PRCA). Considering the possible relationship between the use of liver grafts with high effluent potassium (eK+) concentrations and PRCA, we aimed to investigate the role of eK+ in PRSA development in deceased liver transplantation (LT).
Methods: Using the prospectively collected data from a prior observational study, a retrospective study of 91 adult LT recipients with eK+ measurements between November 2016 and December 2018 was conducted to determine the incidence, predictors, and outcomes of PRSA.
Results: PRSA occurred in 46 cases (50.5%), and PRCA occurred in 8 patients (8.8%). Multivariable analysis demonstrated elevated eK+ concentration before reperfusion (odds ratio [OR], 1.425; 95% confidence interval [CI] 1.134–1.790; P = 0.002), and higher serum potassium level at one minute following reperfusion (sK+1) (OR, 3.244; 95% CI 1.668–6.380; P = 0.001) as independent risk factors for PRSA. An eK+ ≥6.9 mmoL/L could predict PRSA with a sensitivity of 71.7% and a specificity of 80.0% (area under the receiver-operating characteristics curve [AUROC], 0.828). In comparison, an sK+1 ≥5.5 mmoL/L could predict PRSA with a sensitivity of 87.0% and a specificity of 64.4% (AUROC, 0.810). PRSA was associated with increased risks of PRCA, postreperfusion vasoplegia, and postoperative early allograft dysfunction.
Conclusions: This study has demonstrated that eK+ has the potential to predict PRSA in deceased LT. These findings need confirmation in further studies.
Potassium; Effluent; Hyperkalemia; Arrhythmias; Cardiac arrest; Postreperfusion syndrome; Liver transplantation
Liang Zhang,Fu-Shan Xue,Ming Tian,Zhi-Jun Zhu. Standard eﬄuent potassium concentration as a predictive factor for postreperfusion signiﬁcant arrhythmias in deceased liver transplantation. Signa Vitae. 2021.doi:10.22514/sv.2021.121.
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