ArticleNeurocritical care2014
Identifying risk factors for central pontine and extrapontine myelinolysis after liver transplantation: a case-control study.
Article in Neurocritical care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Thalamic Neuron Resilience during Osmotic Demyelination Syndrome (ODS) Is Revealed by Primary Cilium Outgrowth and ADP-ribosylation factor-like protein 13B Labeling in Axon Initial Segment.International journal of molecular sciences · 2023Article
- Evidence-based hyponatremia management in liver disease.Clinical and molecular hepatology · 2023Review
- A woman with focal neurological deficit following treatment for cholera.Malawi medical journal : the journal of Medical Association of Malawi · 2023Article
- A 44-Year-Old Alcohol-Dependent Man Who Recovered from Central Pontine Myelinolysis with Supportive Physical Therapy.The American journal of case reports · 2022Article
- Hyponatremia in Cirrhosis.Clinics in liver disease · 2022Review
- Cerebral Diseases in Liver Transplant Recipients: Systematic Review of Clinical Evidence.Journal of clinical medicine · 2022Review
- Occurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome.SAGE open medical case reports · 2022Article
- The Changing Face of Osmotic Demyelination Syndrome: A Retrospective, Observational Cohort Study.Neurology. Clinical practice · 2021Article
- Central Pontine Myelinosis and Osmotic Demyelination Syndrome.Deutsches Arzteblatt international · 2019Review
- Electrolyte and Acid-Base Disturbances in End-Stage Liver Disease: A Physiopathological Approach.Digestive diseases and sciences · 2017Review
- Hyponatremia in the perioperative period: When and how to correct.Clinical liver disease · 2017Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCentral pontine and extrapontine myelinolysis (CPEPM) is a rare but potentially fatal complication after orthotopic liver transplantation (OLT). The aim of this study was to identify risk factors for development of CPEPM after OLT and to assess patient outcome.
methodsWe reviewed the clinical data of 1,378 patients who underwent OLT between 1987 and 2009 in Geneva, Switzerland and Edmonton, Canada. Nineteen patients (1.4 %) developed CPEPM. We compared their characteristics with control patients, matched by age, gender, date of OLT, and MELD score.
resultsThe 19 patients with CPEPM (7F, mean age 52.1 ± 2 years) had a mean MELD score of 26 ± 2.2. Before OLT, patients who develop CPEPM presented more frequently low (<130 mmol/l; p < 0.04) and very low (<125 mmol/l; p < 0.009) sodium than controls. In patients developing CPEPM, the number of platelet units and fresh frozen plasma transfused during surgery was higher (p = 0.05 and 0.047), hemorrhagic complications were more frequent after OLT (p = 0.049), and variations of sodium before and after OLT were higher (p = 0.023). The association of >2 of these conditions were strongly associated with CPEPM (p = 0.00015). Mortality at 1 year of patients developing CPEPM was higher (63 vs. 13 %, p < 0.0001).
conclusionsHigh MELD score patients undergoing OLT, receiving massive perfusions of Na-rich products, experiencing surgery-related hemorrhagic complication and important fluctuations of Na are at risk of developing CPEPM. Therefore careful monitoring of natremia in the perioperative period and use of water-free perfusion in case of massive blood-products transfusion are critical points of this patient management.
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