In liver transplantation, an increase of serum potassium [K⁺] after reperfusion is related to components of the preservation solution. However, the histidine-tryptophan-ketoglutarate (HTK) solution, which is now popularly used, has a twelve times lower [K⁺] as compared to the UW solution. This retrospective study was performed to compare the use of the UW solution with the HTK solution for changes in the serum [K⁺] during the early reperfusion period in liver transplantation recipients.

Anesthesia medical records of 366 liver transplant patients were reviewed and patients were enrolled in one of the two groups; recipients who received a transplanted liver preserved with the UW solution (UW group), and recipients received a liver preserved with the HTK solution (HTK group). Serum [K⁺] changes 5 min before, 5 min after, and 20 min after reperfusion for recipients in each group were compared.

In the UW group, [K⁺] increased 5 min after reperfusion and decreased 20 min after reperfusion as compared to [K⁺] 5 min before reperfusion (3.93, 4.07, and 3.76 mM in 5 min before, 5 min after, and 20 min after reperfusion respectively; P < 0.001). In the HTK group, [K⁺] significantly decreased 5 min and 20 min after reperfusion as compared to [K⁺] 5 min before reperfusion (4.12, 3.79, and 3.75 mM; P < 0.001).

When the HTK solution was used, the serum [K⁺] 5 min after reperfusion decreased as compared to the [K⁺] before reperfusion and didn't further decrease until 20 min after reperfusion.