Korean J Anesthesiol.  2011 Jun;60(6):408-415. 10.4097/kjae.2011.60.6.408.

The effects of magnesium pretreatment on reperfusion injury during living donor liver transplantation

• Kim JE
• Jeon JP
• No HC
• Choi JH
• Lee SH
• Ryu KH
• Kim ES

• KMID: 1766654
• DOI: http://doi.org/10.4097/kjae.2011.60.6.408

Abstract

BACKGROUND
Ischemia reperfusion (IR) injury is a complex phenomenon that leads to organ dysfunction and causes primary liver failure following liver transplantation. We investigated whether an intravenous administration of magnesium before reperfusion can prevent or reduce IR injury.
METHODS
Fifty-nine living donor liver transplant recipients were randomly assigned to an MG group (n = 31) or an NS group (n = 28). Each group was also divided in two groups based on the preoperative magnesium levels (normal: > or = 0.70 mmol/L, low: < 0.70 mmol/L). The MG groups received 25 mg/kg of MgSO4 mixed in 100 ml normal saline intravenously before reperfusion and the NS groups received an equal volume of normal saline. The levels of lactate, pH, arterial oxygen tension, and base excess were measured to assess reperfusion injury at five specific times, which were 10 min after the beginning of anhepatic phase, and 10, 30, 60 and 120 min after reperfusion. To evaluate postoperative organ function, the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin and creatinine levels were measured at preoperative day 1, postoperative day 1 and 5.
RESULTS
The blood lactate levels were significantly lower at 10, 30, 60 and 120 min after reperfusion in the MG groups compared to the NS groups. In addition, significantly higher blood lactate levels were observed in the NS group with preoperative hypomagnesemia than in MG groups.
CONCLUSIONS
Magnesium administration before reperfusion of liver transplantation significantly reduces blood lactate levels. These findings suggest that magnesium treatment may have protective effects on IR injury during living donor liver transplantation.

Keyword

Ischemia reperfusion injury; Magnesium; Lactate; Living donor liver transplantation

MeSH Terms

Administration, Intravenous
Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
Creatinine
Humans
Hydrogen-Ion Concentration
Ischemia
Lactic Acid
Liver
Liver Failure
Liver Transplantation
Living Donors
Magnesium
Oxygen
Reperfusion
Reperfusion Injury
Alanine Transaminase
Aspartate Aminotransferases
Bilirubin
Creatinine
Lactic Acid
Magnesium
Oxygen