Korean J Anesthesiol.  2005 Oct;49(4):545-549. 10.4097/kjae.2005.49.4.545.

Repeating Cardiac Arrest and One Hour of Cardiopulmonary Resuscitation due to Severe Hyperkalemia after Reperfusion during a Liver Transplantation: A case report

• Kim GS
• Cho HS
• Cha SH
• Koo MS

• KMID: 1936860
• DOI: http://doi.org/10.4097/kjae.2005.49.4.545

Abstract

Liver transplantation still carries considerable risks even if the improvements in surgical and anesthetic techniques lead to a significant decrease in complications. Cardiac arrest during liver transplantation occurs most frequently immediately after the reperfusion due to the influx of hyperkalemic blood from donor liver into a recipient. Cardiac arrest caused by hyperkalemia shows a favorable response to cardiopulmonary resuscitation; however, prolonged cardiopulmonary resuscitation can damage the transplanted liver as well as brain and kidney resulting increased mortality and morbidity rates. The authors experienced repeating cardiac arrest and one hour cardiopulmonary resuscitation due to severe hyperkalemia (8.8 mmol/L) just after the reperfusion during cadaveric liver transplantation. Consciousness was returned 6 hours after operation and vital signs was stable. Transplanted liver well functioned although postoperative course was complicated with acute renal failure, pneumonia and pleural effusion. The patient recovered and discharged 97 days after operation.

Keyword

hyperkalemia; liver transplantation; postreperfusion; prolonged CPR

MeSH Terms

Acute Kidney Injury
Brain
Cadaver
Cardiopulmonary Resuscitation*
Consciousness
Heart Arrest*
Humans
Hyperkalemia*
Kidney
Liver Transplantation*
Liver*
Mortality
Pleural Effusion
Pneumonia
Reperfusion*
Tissue Donors
Vital Signs