Magnesium Supplementation During Liver Transplantation

Abstract

Patients undergoing liver transplantation are prone to hypomagnesemia, with potential deleterious effects. This prospective observational study evaluated the efficacy and safety of routine intraoperative magnesium supplementation to prevent hypomagnesemia. Perioperative serum magnesium levels and electronic anesthesia records of 218 orthotopic liver transplant patients were recorded and analyzed. Data included patient demographics, magnesium dose, blood products infused and cardiac rhythm. The results showed lower prevalence of postoperative hypomagnesemia in patients administered magnesium supplementation compared to patients without supplementation, despite low preoperative serum levels (p=0.03). For patients without supplementation, a high preoperative level prevented hypomagnesemia. A magnesium dose of 3g effectively prevented hypomagnesemia. Magnesium supplementation was associated with 20% risk of mild hypermagnesemia. The prevalence of persistent arrhythmias was 27% and was not higher in hypomagnesemia. The study concludes that routine intraoperative magnesium supplementation reduces the occurrence of postoperative hypomagnesemia, but may not affect the occurrence of arrhythmias.