Intraoperative hypokalemia in pediatric liver transplantation: Incidence and risk factors

Victor W. Xia, Bin Du, Albert Tran, Luke Liu, Ke Qin Hu, Jonathan R. Hiatt, Ronald W. Busuttil, Randolph H. Steadman

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


In this retrospective study of 268 children undergoing liver transplantation, we investigated the incidence of intraoperative potassium (K) disturbances and the risk factors for hypokalemia in the preperfusion and postreperfusion periods. Overall, hypokalemia was the predominant disturbance, occurring in 72.0% of pediatric patients during liver transplantation. Hypokalemia was more common during the postreperfusion period than the prereperfusion period. Hyperkalemia, though a commonly cited complication, was infrequent during pediatric liver transplantation. Using multivariate logistic regression analysis, baseline serum K ≤3.5 mmol/L, base excess >5 mmol/L, and creatinine ≤0.5 mg/dL were found to be predictors for hypokalemia in the prereperfusion period; and body weight ≤15 kg, K ≤3.5 mmol/L, fresh-frozen plasma transfusion >90 mL/kg, and absence of ascites at surgery were independent predictors for hypokalemia in the postreperfusion period. These findings support the use of K replacement to maintain normokalemia and avoid the potential complications related to hypokalemia in pediatric liver transplantation, especially in children with the risk factors for hypokalemia.

Original languageEnglish (US)
Pages (from-to)587-593
Number of pages7
JournalAnesthesia and Analgesia
Issue number3
StatePublished - Sep 2006

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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