INCREASED ANION GAP AFTER LIVER-TRANSPLANTATION

Massive fibrinolysis after a liver transplant resulted in oliguric ren al failure and necessitated the continuous infusion of large quantitie s of fresh frozen plasma. With the increase in plasma protein concentr ation, there was a simultaneous increase in the anion gap. These two p arameters, the anion gap and total protein or albumin level in the blo od, demonstrated a high degree of correlation. Weaker but significant correlations were found in a retrospective analysis of patients with a variety of renal diseases and a population of long-term peritoneal bu t not hemodialysis patients. This entity of hyperproteinemic acidosis should be added to the list of high anion gap acidoses.