According to Miller, “Abnormalities in sodium electrolyte levels are frequently observed and are often related to volume status and sodium retention; these abnormalities can result in either hyponatremia or hypernatremia“. Other common abnormalities in ESLD include hyperkalemia, hypokalemia, and hypomagnesemia.
During the liver transplant itself, hypocalecmia is extremely common during dissection and the anhepatic phases, but also due to chelation of calcium via citrate (most in FFP and platelets, see FFP: Citrate toxicity Dx/Rx)
Electrolyte Abnormalities in ESLD
- Sodium: hyponatremia or hypernatremia (related to volume status)
- Potassium: hyperkalemia or hypokalemia (due to diuretic use)
- Magnesium: hypomagnesemia
- Calcium: hypocalcemia intraoperatively
- W Ray Kim, Scott W Biggins, Walter K Kremers, Russell H Wiesner, Patrick S Kamath, Joanne T Benson, Erick Edwards, Terry M Therneau Hyponatremia and mortality among patients on the liver-transplant waiting list. N. Engl. J. Med.: 2008, 359(10);1018-26