EFFECT OF FLUSHING OF THE LIVER GRAFT UPON PLASMA CALCIUM AND MAGNESIUM CONCENTRATIONS

Previous studies of total and ionized calcium in the plasma of liver t ransplant recipients have been conducted in patients with preexisting liver disease or who received blood transfusion. The intraoperative de cline in plasma total and ionized calcium has been attributed to the e ffects of liver disease and/or the citrate in transfused blood. The pr esent study was conducted in normal porcine recipients of livers store d either with EuroCollins or University of Wisconsin (UW) solution for 6 hr, compared with livers flushed with Ringers's lactate without sto rage. No blood transfusion was given. Mean total plasma calcium levels declined significantly after storage with UW solution to a nadir appr oximately 65-70% of preoperative levels. This decline persisted for tw o to five days. Mean levels of plasma ionized calcium declined lowest after flushing with UW solution but only to 82% of preoperative (NS). There was an increase in plasma total magnesium in the recipients of l ivers flushed with EuroCollins or UW solutions, which resolved within 30 min and which was probably related to magnesium content of the flus hing solution. It is concluded that while the changes in plasma total and ionized calcium are moderate and of little clinical significance, they could be aggravated under clinical conditions by massive blood tr ansfusion. Changes in plasma magnesium seemed to be directly attributa ble to the magnesium content of flushing solutions but the same relati onship did not exist for changes in plasma calcium.