PLASMA MAGNESIUM DURING HUMAN LIVER-TRANSPLANTATION

Patients with severe liver disease and accompanying malnutrition may e xhibit electrolyte disturbances including the magnesium balance. In 18 patients plasma magnesium (p-Mg) was determined at the start of the l iver transplantation and during the anhepatic and reperfusion phases o f the operation. The blood loss was 6.9 (2.5-8.8) l (median and range) and the cumulative transfusion volume was 10.2 (5.0-17.2) l of which 5.9 (2.5-14.2) l was with fresh frozen plasma. p-Mg was 0.72 (0.58-0.8 8) mmol . l(-1) and it did not change significantly during the operati on. Thus, in 4 patients it was at or below the lower reference value o f 0.67 mmol . l(-1). In 11 patients it changed less than 0.05 mmol . l (-1), while in 4 patients the concentration was rose, and in 3 patient s we noted a fall in each of 0.08 mmol . l(-1). There was no correlati on between p-Mg and the blood loss or the administered volume of fresh frozen plasma. In 10 randomly chosen fresh frozen plasma units, the p -Mg was 0.64 (0.61-0.71) mmol . l(-1). These observations do not suppo rt a need for close monitoring or substitution of magnesium during hum an liver transplantation. On the other hand, the finding of a low valu e in 4 of 18 patients suggests that plasma magnesium should be monitor ed and eventually corrected while the patient is on the waiting list.