Background: In liver transplantation, an increase of serum potassium [K＋] after reperfusion is related to components of the preservation solution. However, the histidine-tryptophan-ketoglutarate (HTK) solution, which is now popularly used, has a twelve times lower [K＋] as compared to the UW solution. This retrospective study was performed to compare the use of the UW solution with the HTK solution for changes in the serum [K＋] during the early reperfusion period in liver transplantation recipients. Methods: Anesthesia medical records of 366 liver transplant patients were reviewed and patients were enrolled in one of the two groups; recipients who received a transplanted liver preserved with the UW solution (UW group), and recipients received a liver preserved with the HTK solution (HTK group). Serum [K＋] changes 5 min before, 5 min after, and 20 min after reperfusion for recipients in each group were compared. Results: In the UW group, [K＋] increased 5 min after reperfusion and decreased 20 min after reperfusion as compared to [K＋] 5 min before reperfusion (3.93, 4.07, and 3.76 mM in 5 min before, 5 min after, and 20 min after reperfusion respectively; P ＜ 0.001). In the HTK group, [K＋] significantly decreased 5 min and 20 min after reperfusion as compared to [K＋] 5 min before reperfusion (4.12, 3.79, and 3.75 mM; P ＜ 0.001). Conclusions: When the HTK solution was used, the serum [K＋] 5 min after reperfusion decreased as compared to the [K＋] before reperfusion and didn't further decrease until 20 min after reperfusion.
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