Related Experiment Videos
Ionized calcium levels during liver transplantation.
1Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, United Kingdom.
European Journal of Anaesthesiology
|November 1, 1987
Summary
During liver transplants, ionized calcium levels drop due to citrate in blood products, especially when the liver isn't functioning. Prompt calcium chloride administration is crucial to manage this intraoperative hypocalcemia.
Area of Science:
- Anesthesiology
- Transplant Surgery
- Clinical Chemistry
Background:
- Liver transplantation is a complex procedure with significant physiological challenges.
- Maintaining electrolyte balance, particularly calcium levels, is critical during surgery.
Purpose of the Study:
- To investigate the changes in plasma ionized calcium and total calcium during liver transplant operations.
- To understand the relationship between calcium levels, citrate-containing blood products, and liver function.
Main Methods:
- Measurement of plasma ionized calcium and total calcium concentrations in 26 liver transplant patients.
- Monitoring calcium levels throughout the surgical procedure, including the anhepatic phase.
- Administration of calcium chloride to correct observed decreases.
Main Results:
- Ionized calcium levels decreased during the early stages of surgery, reaching nadir during the anhepatic period.
- Calcium levels increased post-reanastomosis of the new liver.
- Decreases in ionized calcium were associated with the transfusion of blood products preserved with citrate-phosphate-dextrose-adenine (CPD-A).
Conclusions:
- Intraoperative citrate loading, combined with impaired liver function (especially during the anhepatic phase), leads to ionic hypocalcemia.
- Aggressive correction of low ionized calcium levels is necessary to prevent adverse effects during liver transplantation.