Changes in haemodynamics and electrolytes during perioperative period of living donor liver transplantation in children and their preventive measures

Abstract

To explore the preventive measures of disturbances of haemodynamics and electrolytes by observing their changes during perioperative period of living donor liver transplantation in children. Twenty children who had undergone living donor liver transplantation operation were enrolled in the study, their haemodynamics and electrolyte parameters before operation and on the 1, 3, 5 and 7 days after the operation were monitored and analyzed. Compared with levels before operation , systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) significantly increased on the 1, 3, 5 and 7 days after the operation [SBP(mm Hg, 1 mm Hg=0.133 kPa): 106.60 ± 9.58, 116.75 ± 9.11, 117.95 ± 12.15, 116.45 ± 8.73 vs. 92.75 ± 6.72,DBP(mm Hg): 63.85 ± 10.33, 70.70 ± 10.98, 70.90 ± 12.92, 74.65 ± 15.51 vs. 53.95 ± 12.43,MAP (mm Hg):78.15 ± 9.30, 85.30 ± 9.44, 85.35 ± 13.85, 85.90 ± 13.94 vs. 66.45 ± 8.83, all P <0.05], but the heart rate (HR, bpm)was significant lowered only on 5 days after the operation (102.80 ± 26.08 vs. 117.25 ± 19.25,P<0.05). Blood Na(+) (mmol/L)level rose significantly on the 1 day after the operation (146.52 ± 5.89 vs. 139.36 ± 3.91,P<0.01). On the same day, blood K(+) and Ca(2+) were declined significantly [K(+) (mmol/L): 3.36 ± 0.44 vs. 4.12 ± 0.68, Ca(2+) (mmol/L): 1.15 ± 0.15 vs. 1.23 ± 0.06,P<0.01 and P <0.05], but there was no obvious change in them on 3, 5 and 7 days. Significant decrease in blood Mg(2+) (mmol/L) was found on the 1, 3, 5 and 7 days after the operation (0.69 ± 0.11, 0.64 ± 0.10, 0.58 ± 0.10, 0.72 ± 0.17 vs. 0.84 ± 0.10,P<0.05 or P <0.01). Hypertension is the main haemodynamics change during perioperative period of living donor liver transplantation in children, and the levels of electrolytes are not stable in early postoperative period of liver transplantation. Early diagnosis and treatment of hypertension is important for children to recover from operation , and it is also important to maintain normal levels of electrolytes to obtain a successful liver transplantation.