Refractory Hyperkalemia During Simultaneous Liver And Kidney Transplantation
A 58-year-old female with a past medical history of hypertension, alcoholic cirrhosis and portal hypertension presented to the hospital for a simultaneous liver and kidney transplant. Partway through the case, the patient developed hyperkalemia with a peak potassium of 7.8 mmol/L as measured on a critical care panel, due to massive transfusion needs. Treatment included administration of over 200 units of Regular Human Insulin. The focus of this case discussion will be on the etiology of hyperkalemia, its pathophysiologic impacts in regards to anesthetic care, and the various treatment modalities that are available inside of the operating room.
Aiello A, Ojeda J, Kado J, Zhang J. Refractory hyperkalemia during simultaneous liver and kidney transplantation. Presented at: American Society of Anesthesiology Annual Meeting; 2022 Oct 21-25; New Orleans, LA.