title: Hyperaluminemia associated with liver transplantation and acute renal failure.
abstract: Iatrogenic aluminium toxicity is reported in a patient who underwent an orthotopic liver transplant and who had concomitant renal failure requiring hemodialysis. Following transplantation the patient developed a metabolic encephalopathy with only mildly elevated blood ammonia concentrations. During the period following transplantation the patient received massive infusions of albumin and was on oral feeding (vivonexten), both of which contained aluminium, as did the dialysis fluid. Hyperaluminemia and profoundly elevated liver tissue aluminium concentrations were observed. Treatment with desferrioxamine, a trivalent ion chelator, decreased the plasma aluminium concentrations with an improvement in the patient's mental status.
authors.affiliation: Department of Pathology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Erasmus
authors.forename: J
authors.initials: J
authors.lastname: Kusnir
authors.forename: W C
authors.initials: WC
authors.lastname: Stevenson
authors.forename: P
authors.initials: P
authors.lastname: Lobo
authors.forename: M M
authors.initials: MM
authors.lastname: Herman
authors.forename: M R
authors.initials: MR
authors.lastname: Wills
authors.forename: J
authors.initials: J
authors.lastname: Savory
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000628:therapy; D000418:Albumins / Q000009:adverse effects; D000535:Aluminum / Q000032:analysis / Q000097:blood* / Q000506:poisoning; D000641:Ammonia / Q000097:blood; D000931:Antidotes / Q000627:therapeutic use; D002614:Chelating Agents / Q000627:therapeutic use; D003128:Coma / Q000209:etiology / Q000378:metabolism; D003676:Deferoxamine / Q000627:therapeutic use; D015314:Dialysis Solutions / Q000009:adverse effects / Q000032:analysis; D004750:Enteral Nutrition; D005260:Female; D005503:Food Additives / Q000009:adverse effects / Q000032:analysis; D005526:Food, Formulated / Q000009:adverse effects / Q000032:analysis; D006801:Humans; D008099:Liver / Q000737:chemistry; D016031:Liver Transplantation; D008875:Middle Aged; D009930:Organic Chemicals; D006435:Renal Dialysis / Q000009:adverse effects; D012640:Seizures / Q000209:etiology / Q000378:metabolism
chemical_list: D000418:Albumins; D000931:Antidotes; D002614:Chelating Agents; D015314:Dialysis Solutions; D005503:Food Additives; D009930:Organic Chemicals; D000641:Ammonia; C011567:Vivonex; D000535:Aluminum; D003676:Deferoxamine