The Wisconsin solution contains 115—120 meq/L K+. The perfusion of the blood of the receiver into the liver of the donor causes a temporary increase of 1—2 meq/L K+. However, this increase may be dangerous particularly in pediatric cases. We present a 7.5 month old, 7200 gram female baby who was diagnosed with neonatal cholestatic hepatitis and underwent surgical operation as a liver transplant recipient. Five hundered ml protective Wisconsin solution was given to the left lobe of the liver which was taken from the mother. K+ value of the receiver at the end of anhepatic phase was 4.5 meq/L. In order to clean the donor liver from the Wisconsin solution and particularly from K, the washing solution was prepared by putting 100 ml of %20 albumin concentrate in to 1000cc dextrose%5 before the neohepatic phase. 250 cc of this solution was given to donor liver until the washing liquid that expels from the donor liver became limpid. As the washing was considered to be inadequate, this process was sustained by giving 800 cc washing solution. The first K+ value measured after reperfusion was 5.5 meq/L. The operation was completed without any complication and no problem was encountered in 6 month postoperative follow up. No information was found in literature regarding what amount of washing solution is to be used for reducing the K+ burden that occurs on the receiver as a result of K+ rich Wisconsin solution (115—120 meq/lt) which is used in order to protect the organ during liver transplantation. Organ washing procedure is conventionally extended until washing solution becomes clear. However, in pediatric cases an increment of 1meq/L K+ may be of importance. For this reason in pediatric cases we propose that the washing procedure not be extended until the washing solution becomes clear but until the 1000cc albumin dextrose solution finishes.
Volume : 6
Issue : 4
Pages : 158
Anesthesiology and Reanimation Department, Transplantation Unit, Gazi University Medical Faculty, Ankara, Turkey