From the Research
Optimal Potassium Level for Liver Transplant Donor
The optimal potassium level for a liver transplant donor prior to surgery is not explicitly stated in the provided studies. However, the studies suggest that hyperkalemia is a common cause of arrhythmias in patients undergoing liver transplantation 1, 2, 3, 4, 5.
Factors Associated with Hyperkalemia
Several factors are associated with the development of hyperkalemia in liver transplant recipients, including:
- Higher pre-reperfusion potassium levels 1, 3
- Macrosteatosis in the donor liver 5
- Use of extended criteria donor (ECD) grafts 2
- Donation after cardiac death (DCD) grafts with pathological changes 5
Potassium Levels in Different Studies
The studies report the following potassium levels:
- Baseline median potassium levels: 4.1 mmol/L 1
- Peak potassium levels: 4.45 mmol/L 1
- Blood potassium levels after reperfusion: 3.8 ± 0.4 and 3.9 ± 0.4 mEq/L 3
- Potassium shifts during dual hypothermic oxygenated machine perfusion (DHOPE): -17 ± 2 mmol and -34 ± 6 mmol 4
Management of Hyperkalemia
The studies suggest that measuring flush fluid potassium concentration (FFK) can help identify donors at risk of hyperkalemia 2. Additionally, strategies such as portal vein flush, retrograde reperfusion, and antegrade reperfusion can be used to remove excessive potassium ions 2.