The changes of hemodynamics and electrolyte in orthotopic liver transplantation without venovenous bypass

Objective To investigate the clinical significance of the changes of hemodynamics and electrolyte during orthotopc liver transplantation.Methods We studied 9 patients undergoing elective orthotopic liver transplantation without venovenous bypass,drew out arterial blood for monitoring arterial blood gas tensions,Na~+,K~+,Ca~(2+) and observed changes in hemodynamics and electrolyte.Results In most patients,arterial pressure significantly decreased at the prophase of the anhepatic phase,and tended to normal range in other phases.The concentration of calcium maintained a low-level during the whole surgery.During the prophases of the anhepatic phase and neo-hepatic phase,there was a light hyperkalemia,and the concentration of natrium slightly increased since 30 minutes after the anhepatic phase and neohepatic phase,but insensibly exceeded normal range.With resuming of the stability of hemodynamics,these changes had followed.Conclusion We shoud give our attention to correct the occurrence of the hypocalcemia during the forepart of the anhepatic phase and neo hepatic phase,and care for the hyperkalemia 5 minutes after the block of liver blood purveyance and revascularization of liver.The lock of body capability shoud be recruit duly according to the lose of blood and hemacytometer changes.In order to prevent serious academia and maintain the stability of hemodynamics and electrolyte,vasoconstrictor shoud be used carefully during the anhepatic phase.