| Repeating Cardiac Arrest and One Hour of Cardiopulmonary Resuscitation due to Severe Hyperkalemia after Reperfusion during a Liver Transplantation: A case report. |
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Gaab Soo Kim, Hyun Sung Cho, Sang Hyun Cha, Myoung Shin Koo |
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Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gskim@smc.samsung.co.kr |
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| Abstract |
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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. |
| Key Words:
hyperkalemia; liver transplantation; postreperfusion; prolonged CPR |
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