摘要
Hyperkalemia is a recognized and potentially life-threatening complication ofheart transplantation. In the complex biosystem created by transplantation,recipients are susceptible to multiple mechanisms for hyperkalemia which arediscussed in detail in this manuscript. Hyperkalemia in heart transplantationcould occur pre-transplant, during the transplant period, or post-transplant. Pretransplantcauses of hyperkalemia include hypothermia, donor heart preservationsolutions, conventional cardioplegia, normokalemic cardioplegia, continuouswarm reperfusion technique, and ex-vivo heart perfusion. Intra-transplant causesof hyperkalemia include anesthetic medications used during the procedure,heparinization, blood transfusions, and a low output state. Finally, post-transplantcauses of hyperkalemia include hemostasis and drug-induced hyperkalemia.Hyperkalemia has been studied in kidney and liver transplant recipients, butthere is limited data on the incidence, causes, management, and prevention inheart transplant recipients. Hyperkalemia is associated with an increased risk ofhospital mortality and readmission in these patients. This review describes thecurrent literature pertaining to the causes, pathophysiology, and treatment ofhyperkalemia in patients undergoing heart transplantation and focuses primarilyon post-heart transplantation.
