{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:40:53Z","timestamp":1776721253230,"version":"3.51.2"},"reference-count":31,"publisher":"The Korean Society of Anesthesiologists","issue":"4","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekja.org"],"crossmark-restriction":true},"short-container-title":["Korean J Anesthesiol"],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:p>Background: The ideal intravenous maintenance and resuscitation fluid for patients undergoing orthotopic liver transplantation (OLT) remains unknown. We aimed to determine whether bicarbonate-buffered solution was non-inferior to Plasma-LyteTM in preventing metabolic acidosis during OLT.Methods: We conducted a pilot single-center, open-label, randomized trial to compare the physiological effects of intravascular volume maintenance with a bicarbonate-buffered solution vs. Plasma-LyteTM in adults undergoing OLT. Non-inferiority was defined as a median difference in the standard base excess (SBE) of less than \u22122.5 mEq\/L. The primary endpoint was the SBE at 5 minutes post-reperfusion. Quantile regression analysis was applied to confirm non-inferiority. Secondary endpoints included other forms of acid-base and electrolyte imbalances at pre-specified time points and postoperative complications.Results: We randomized 52 adults undergoing OLT. The median (Q1, Q3) volume infused was 5\u2009000 (3\u2009125, 7\u2009000) ml in the bicarbonate-buffered solution group and 5\u2009500 (4\u2009000, 10\u2009500) ml in the Plasma-LyteTM group (P = 0.37). The median (Q1, Q3) SBE at 5 minutes post-reperfusion was \u22124.857 (\u22126.231, \u22123.565) mEq\/L in patients receiving bicarbonate-buffered solution and \u22124.749 (\u22127.574, \u22122.963) mEq\/L amongst those in the Plasma-LyteTM group. The estimated median difference by quantile regression was \u22120.043 mEq\/L (95% CI [\u22121.988 to 1.902] mEq\/L; one-sided P = 0.015). There were no significant differences in the acid-base secondary outcomes, number of complications, or patient mortality. There were no reported adverse events or safety concerns associated with the use of either solution.Conclusions: A bicarbonate-buffered solution was non-inferior to Plasma-LyteTM for maintaining acid-base homeostasis post-reperfusion in OLT patients.<\/jats:p>","DOI":"10.4097\/kja.24677","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T02:37:50Z","timestamp":1739846270000},"page":"369-381","update-policy":"https:\/\/doi.org\/10.4097\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bicarbonate-buffered solution versus Plasma-LyteTM in orthotopic adult liver transplantation: a pilot open-label, randomized, non-inferiority 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