Objective:To investigate the clinical significance of changes of acid-base and electrolytes in different phases during the procedure of orthotopic liver transplantation(OLT). Methods:Forty-six recipients who underwent liver transplantation with the piggyback technique under general anaesthesia were analyzed retrospectively. Blood samples collected during the phase of procedure for values included arterial pH,partial carbon dioxide pressure(PaCO2),standard bicarbonate values(HCO3-) and serum potassium(K+),ionized calcium(Ca2+),sodium(Na+),blood glucose levels(BG). The measurements were performed at nine time points:20 min after the skin incision(baseline),10,20,30,60 minutes during the anhepatic phase,and 10,20,30,60 minutes after reperfusion. Results:The pH in the phase of revascularization of liver was significantly lower at 10 min,20 min and 30 min(P < 0.001,P < 0.001 and P < 0.05,respectively); PCO2 was higher in anhepatic phase at 60 min(P < 0.05) and in the phase of revascularization of liver at all time points(P < 0.001,P < 0.001,P < 0.001 and P < 0.05,respectively); HCO3- was higher during anhepatic phase at 20 min,30 min and 60 min(P < 0.001,P < 0.01 and P < 0.01,respectively) and 10 min,20 min and 30 min during the phase of revascularization(P < 0.001,P < 0.01 and P < 0.01,respectively). K+ and Na+decreased significantly in the phase of revascularization at 10 min time point(P < 0.001,P < 0.01,respectively). No difference of Ca2+ was observed among the nine time points during the phases of procedure. Mean glucose levels increased in anhepatic phase at 10 min,20 min(both P < 0.05) and 10 min,20 min,30 min during the phase of revascularization(P < 0.001,P < 0.01 and P < 0.01,respectively). Conclusion:Mixed acid-base disturbances were observed in the early stage of revascularization phase during the procedure of OLT.