ArticleWorld journal of gastroenterology2004
Possible causes of central pontine myelinolysis after liver transplantation.
Article in World journal of gastroenterology, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 91 citations in OpenAlex.
- Neurocognitive-neurological complications of liver transplantation: a review.Metabolic brain disease · 2010Pooled it
- Critical Assessment of the Neurological Complications during High-Risk Anesthesia Procedures.Journal of surgery and research · 2024Article
- Cerebral Diseases in Liver Transplant Recipients: Systematic Review of Clinical Evidence.Journal of clinical medicine · 2022Review
- Prognostic Impact of Peritransplant Serum Sodium Concentrations in Liver Transplantation.Annals of transplantation · 2019Article
- Hyponatremia in the intensive care unit: How to avoid a Zugzwang situation?Annals of intensive care · 2015Article
- The Effect of Intraoperative Restricted Normal Saline during Orthotopic Liver Transplantation on Amount of Administered Sodium Bicarbonate.Iranian journal of medical sciences · 2014Article
- Identifying risk factors for central pontine and extrapontine myelinolysis after liver transplantation: a case-control study.Neurocritical care · 2014Article
- Corticospinal tract and pontocerebellar fiber of central pontine myelinolysis.Annals of rehabilitation medicine · 2012Article
- Central pontine and extrapontine myelinolysis: from epileptic and other manifestations to cognitive prognosis.Journal of neurology · 2010Article
- Therapy of central pontine myelinolysis following living donor liver transplantation: Report of three cases.World journal of gastroenterology · 2009Article
- Central pontine myelinolysis following bone marrow transplantation complicated by severe hepatic veno-occlusive disease.Bone marrow transplantation · 2005Article
- Article
- Tacrolimus-induced Central Pontine Myelinolysis in a Pediatric Liver Transplant Recipient.Journal of clinical and experimental hepatologyArticle
- A Case of Central Pontine Myelinolysis Caused by Hypophosphatemia Secondary to Refeeding Syndrome.Case reports in neurologyArticle
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo sum up the clinical characteristics of patients with central pontine myelinolysis (CPM) after orthotopic liver transplantation (OLT) and to document the possible causes of CPM.
methodsData of 142 patients undergoing OLT between January 1999 to May 2003 were analyzed retrospectively. Following risk factors during perioperation were analyzed in patients with and without CPM: primary liver disease, preoperative serum sodium level, magnesium level and plasma osmolality, fluctuation degree of serum sodium concentration, and immunosuppressive drug level, etc.
resultsA total of 13 (9.2%) neurologic symptoms appeared in 142 patients post-operation including 5 cases (3.5%) with CPM and 8 cases (5.6%) with cerebral hemorrhage or infarct. Two patients developing CPM after OLT had a hyponatremia history before operation (serum sodium<130 mmol/L), their mean serum sodium level was 130.6 +/- 5.54 mmol/L. The serum sodium level was significantly lower in CPM patients than in patients without neurologic complications or with cerebral hemorrhage/infarct (P<0.05). The increase in serum sodiumduring perioperative 48 h after OLT in patients with CPM was significantly greater than that in patients with cerebral hemorrhage/infarct but without neurologic complications (19.5 +/- 6.54 mmol/L, 10.1 +/- 6.43 mmol/L, 4.5 +/- 4.34 mmol/L, respectively, P<0.05). Plasma osmolality was greatly increased postoperation in patients with CPM. Hypomagnesemia was noted in all patients perioperation, but there were no significant differences between groups. The duration of operation on patients with CPM was longer than that on others (492 +/- 190.05 min, P<0.05). Cyclosporin A (CsA) levels were normal in all patients, but there were significant differences between patients with or without neurologic complications (P<0.05).
conclusionCPM may be more prevalent following liver transplantation. Although the diagnosis of CPM after OLT can be made by overall neurologic evaluations including magnetic resonance imaging (MRI) of the head, the mortality is still very high. The occurance of CPM may be associated with such factors as hyponatremia, rapid rise of serum sodium concentration, plasma osmolality increase postoperation, the duration of operation, and high CsA levels.
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