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Original Research

Open Access Special Issue

Standard effluent potassium concentration as a predictive factor for postreperfusion significant arrhythmias in deceased liver transplantation

  • Liang Zhang1
  • Fu-Shan Xue1
  • Ming Tian1
  • Zhi-Jun Zhu2,*,

1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China

2Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 100050 Beijing, China

DOI: 10.22514/sv.2021.121 Vol.18,Issue 3,May 2022 pp.75-80

Submitted: 01 May 2021 Accepted: 31 May 2021

Published: 08 May 2022


*Corresponding Author(s): Ming Tian E-mail:
*Corresponding Author(s): Zhi-Jun Zhu E-mail:


Postreperfusion significant arrhythmias (PRSA), which is known as part of the diagnostic criteria for postreperfusion syndrome, may serve as a precursor of postreperfusion cardiac arrest (PRCA). Considering the possible relationship between the use of liver grafts with high effluent potassium (eK+) concentrations and PRCA, we aimed to investigate the role of eK+ in PRSA development in deceased liver transplantation (LT). Using the prospectively collected data from a prior observational study, a retrospective study of 91 adult LT recipients with eK+ measurements between November 2016 and December 2018 was conducted to determine the incidence, predictors, and outcomes of PRSA. PRSA occurred in 46 cases (50.5%), and PRCA occurred in 8 patients (8.8%). Multivariable analysis demonstrated elevated eK+ concentration before reperfusion (odds ratio [OR], 1.425; 95% confidence interval [CI] 1.134–1.790; P = 0.002), and higher serum potassium level at one minute following reperfusion (sK+1) (OR, 3.244; 95% CI 1.668–6.380; P = 0.001) as independent risk factors for PRSA. An eK+ ≥6.9 mmoL/L could predict PRSA with a sensitivity of 71.7% and a specificity of 80.0% (area under the receiver-operating characteristics curve [AUROC], 0.828). In comparison, an sK+1 ≥5.5 mmoL/L could predict PRSA with a sensitivity of 87.0% and a specificity of 64.4% (AUROC, 0.810). PRSA was associated with increased risks of PRCA, postreperfusion vasoplegia, and postoperative early allograft dysfunction. This study has demonstrated that eK+ has the potential to predict PRSA in deceased LT.


Potassium; Effluent; Hyperkalemia; Arrhythmias; Cardiac arrest; Postreperfusion syndrome; Liver transplantation

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Liang Zhang,Fu-Shan Xue,Ming Tian,Zhi-Jun Zhu. Standard effluent potassium concentration as a predictive factor for postreperfusion significant arrhythmias in deceased liver transplantation. SignaVitae. 2022. 18(3);75-80.


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