Acute hyperkalemia risks in recipients of kidney graft cooled with Collins' solution

The authors present the first case of cardiac arrest, occurring at the time of vessel clamps removal, of a kidney transplantation cooled prior to grafting with Collin's solution. Monitoring of cardiac (K) has demonstrated the role of Collin's solution (K = 141 mEq/l) in the genesis of this incident. The mean +/- SD increase of the K concentration in the right atrium within the seconds following the removal of the graft vessels clamps was 2.6 +/- 1.5 mEq. Acute electrocardiographic abnormalities primarily represented by sudden apparition of hyperkalemic T waves and extrasystols occurs in more than 50% of the cases. The effects of progressive blood release in the graft and other preventive manipulations are studied and discussed.