Fluid and Electrolyte Disorders Associated with Orthotopic Liver Transplantation
Following the NIH Consensus Development Conference on Liver Transplantation (1) in 1984 there has been a rapid increase in the use of transplantation to treat end stage liver disease (2). As a result it has become apparent that a more aggressive approach has to be taken towards the medical management of patients who would previously have been considered terminally ill (3, 4). In addition the operative and postoperative periods are characterised by unique fluid and electrolyte problems (5–11). A number of studies (12–18) have shown that pre-existing renal dysfunction has a significant impact on the post-operative prognosis, and that the need for hemodialysis following transplantation is associated with increased mortality. The various phases of the operation itself and the massive blood transfusions produce calcium and acid-base disorders which necessitate careful intra- and post-operative monitoring.
KeywordsLiver Transplantation Orthotopic Liver Transplantation Metabolic Alkalosis Follow Liver Transplantation Ionise Calcium Level
Unable to display preview. Download preview PDF.
- 5.Grenvik A, Gordon R: Postoperative care and problems in liver transplantation. Trans Proc, 19(S4): 17–20, 1987.Google Scholar
- 14.Danovitch GM, Wilkinson AH, Colonna JO, Busuttil RW: Determinants of renal failure in patients receiving orthotopic liver transplants. Kidney Int, 31: 195, 1987.Google Scholar
- 38.Gonwa TA, Poplawski SC, Husberg BS, Nery JR, Klintmalm GB: Cyclosporine nephrotoxicity in orthotopic liver transplantation. Trans Proc, 20(S3): 401–404, 1988.Google Scholar
- 39.Iwatsuki S, Esquivai CO, Klintmalm GB, Gordon RD, Shaw BW, Starzl TE: Nephrotoxicity of cyclosporine in liver transplantation. Trans Proc, 17(S1): 191–195, 1985.Google Scholar
- 42.Neumayer HH, Wagner K: Prevention of delayed graft function in cadaver kidney transplants by diltiazem: outcome of two prospective randomised clinical trials. J Cardiovasc Pharm, 10: S170-S177, 1987.Google Scholar
- 49.McDiarmid SV, Ettenger RB, Senguttvan P, Hawkins R, Busuttil RW, Ament ME: The impairment of the true GFR in pediatric liver transplant recipients. Transplantation, 1989 (in press).Google Scholar
- 51.Williams R, Blackburn A, Neuberger J, Calne RY: Long-term use of cyclosporine in liver grafting. Q J Med, 224: 897–905, 1985.Google Scholar
- 54.Slomowitz LA, Wilkinson AH, Hawkins RA, Danovitch GM: Evaluation of kidney function in renal transplant patients receiving long-term cyclosporine. Am J Kidney Dis, 1989 (in press).Google Scholar
- 55.Khoury GF, Kaufman RD, Musich JA, Mogard M: Neurotensin and vasoactive intestinal peptide levels during orthotopic liver transplantation. Anesth Analg, 65: S79-S79, 1986.(Abstract)Google Scholar