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Background: Postreperfusion hyperkalemia (PRHK) has garnered increasing attention in regard to deceased liver transplantation (LT), especially for LT using the expanded criteria donor grafts. However, the impact of the effluent potassium (eK+) concentration on PRHK has been largely overlooked. We evaluated whether elevated eK+ concentrations are associated with PRHK in deceased LT. Methods: In this single-institution, retrospective cohort study, we included all adults who underwent deceased LT with intraoperative eK+ concentration monitoring between November 2016 and December 2018. The eK+ concentrations were obtained from the effluent samples collected following a standard portal vein flush. PRHK was defined as any serum potassium (sK+) level of > 5.5 mmol/L following reperfusion. Logistic regression was performed to identify predictors for PRHK, and linear regression was used to examine predictors of the maximum percentage increase in the sK+ level following reperfusion. Results: Of the 86 patients who met the inclusion criteria, 54 (62.8%) developed PRHK. Independent predictors for PRHK included greater graft weight (OR 1.283 [95% CI 1.029–1.599] per 100 g, P = 0.027), an elevated eK+ concentration (OR 1.291 [95% CI 1.068–1.561] per mol/L, P = 0.008), and a higher sK+ level before reperfusion (OR 4.459 [95% CI 1.543–12.884] per mol/L, P = 0.006). An eK+ concentration of more than 6.9 mmol/L had a sensitivity of 59.26% and a specificity of 78.12% for predicting PRHK (area under the receiver operating characteristic curve, 0.694). Multiple linear regression analyses indicated that the eK+ and sK+ levels before reperfusion were significant predictors of the maximum percentage increase in the sK+ level following reperfusion. In addition, PRHK was associated with an increased risk of postreperfusion significant arrhythmias, severe postreperfusion syndrome, and postoperative early allograft dysfunction. Conclusions: This study shows that the eK+ concentration could predict the risk of PRHK in deceased LT. Further prospective studies are warranted to clarify these associations. [ABSTRACT FROM AUTHOR]

The letter to the editor made several comments regarding possible methodological issues in the recent article by Lin et al. determining the association between blood glucose variability and postoperative delirium in patients undergoing acute aortic dissection surgery with cardiopulmonary bypass, which is published in Journal of Cardiothoracic Surgery. 2021; 16(1):82. Our concerns included the lack of some important perioperative factors associated with postoperative delirium, the process of establishing multivariate model and the method of using the receiver operating characteristic curve analysis to assess the predictive performance of the standard deviation of blood glucose for the development of POD. We would like to invite the authors to comment on these and believe that clarifying these issues would improve the transparency of this study and interpretation of findings. [ABSTRACT FROM AUTHOR]

Dear Editor, In the recent article by Zorrilla-Vaca et al. [[1]] examining the risk factors of postoperative acute kidney injury (AKI) in patients undergoing colorectal surgery with an enhanced recovery pathway, we noted that several methodological issues were not addressed well. Third, by multivariable analysis, age > 60 years, male gender, American Society of Anesthesiologists physical status classifications III-IV, chronic kidney disease and hypoalbuminemia were identified as independent risk factors of postoperative AKI. As the diagnostic criteria of chronic kidney disease were not provided in the Methods section, it was unclear whether patients with occult or mild chronic kidney disease (stages 1 and 2) were included in the study. [Extracted from the article]

Dear Editor, By a retrospective analysis, Du et al. [[1]] assessed the incidence and risk factors of early-onset acute kidney injury (AKI) during the first week after lung transplantation and its association with postoperative mortality. First, the study objects are patients with end-stage lung disease undergoing lung transplantation. [Extracted from the article]

The authors comment on a study which compared the effects of hydroxyethyl starch (HES) and 0.9 percent saline for intravascular volume expansion on postoperative mortality and complications in patients undergoing major abdominal surgery. Topics include how acute kidney injury (AKI) was defined in the study, factors that could have biased findings, and possible impact of the short observation period for AKI in the study.

The letter to the editor made several comments on possible issues in the recent article by Zhang et al. determining the risk factors of acute kidney injury after pulmonary endarterectomy with cardiopulmonary bypass, which has been published in Journal of Cardiothoracic Surgery at December 30, 2019. [ABSTRACT FROM AUTHOR]

See the Reply by Zattoni et al. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article by MacDonald et al which assessed the epidemiology of acute kidney injury (AKI) after pediatric heart transplant surgery in terms of risk factors and outcome.

With a great interest we read the recent article by Neuman et al1 assessing the association between mean systemic filling pressure analogue (Pmsa ) and acute kidney injury (AKI) following cardiac surgery. They showed that Pmsa as a surrogate for renal venous pressure was more closely associated with AKI than central venous pressure. As AKI has been significantly associated with morbidity and mortality in after cardiac surgery,2 their findings have potential implication. Other than the limitations described by authors in discussion, however, we noted several issues in their article on which we invited the authors to comment. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Prevalence of preoperative anaemia in patients having first-time cardiac surgery and its impact on clinical outcome" by C. J. Kim and colleagues that was published in a previous issue.

A letter to the editor is presented in response to the article "Risk factors of postoperative myocardial infarction after colorectal surgeries" by Z. Moghadamyeghaneh and colleagues in the August 2015 issue.

A letter to the editor is presented in response to the article "Low Albumin Levels, More Than Morbid Obesity, Are Associated With Complications After TKA" by Fu-Shan Xue and colleagues published in a previous issue is presented.