Plasma magnesium during human liver transplantation

Area of Science:

• Transplantation Medicine
• Clinical Chemistry
• Critical Care Medicine

Background:

• Severe liver disease and malnutrition can cause electrolyte imbalances, including magnesium disturbances.
• Magnesium is crucial for various physiological processes.
• Electrolyte balance is critical in patients undergoing major surgery like liver transplantation.

Purpose of the Study:

• To investigate plasma magnesium (p-Mg) levels in patients undergoing liver transplantation.
• To determine if p-Mg levels change significantly during the surgical procedure.
• To assess the need for magnesium monitoring or supplementation during liver transplantation.

Main Methods:

• Plasma magnesium was measured in 18 patients at the start, during the anhepatic, and reperfusion phases of liver transplantation.
• Blood loss and transfusion volumes (including fresh frozen plasma) were recorded.
• Magnesium content in fresh frozen plasma units was analyzed.

Main Results:

• Plasma magnesium levels did not change significantly throughout the liver transplantation procedure.
• Four out of 18 patients had pre-transplant p-Mg at or below the lower reference value.
• No correlation was found between p-Mg levels and blood loss or fresh frozen plasma volume administered.

Conclusions:

• Routine monitoring and magnesium supplementation are not indicated during liver transplantation itself.
• Pre-transplant plasma magnesium monitoring is advisable for liver transplant candidates.
• Low magnesium levels identified pre-transplant may require correction before surgery.