A 3-week-old infant with liver failure underwent an orthotopic liver t
ransplant. Following a prolonged second surgical procedure in which he
received massive amounts of blood products, his serum calcium was 31.
3. mg/dl (7.8 mmol/l). This patient represents a case of severe hyperc
alcemia secondary to intraoperative calcium infusions given in an effo
rt to overcome infusion-related citrate toxicity in a neonate with hep
atic dysfunction.