title: Therapy of central pontine myelinolysis following living donor liver transplantation: Report of three cases.
abstract: We analyzed the clinical manifestations and experiences of diagnosing and treating central pontine myelinolysis following living donor liver transplantation. The clinical data of three patients with central pontine myelinolysis following living donor liver transplantation from January 2005 to November 2007 were retrospectively analyzed at the West China Hospital, Sichuan University, China. The three patients developed hyponatremia prior to surgery. Case 1 suffered locked-in syndrome following surgery, and received a large dose of gamma globulin, and subsequently recovered. Case 2 was in a coma for three days, and received hyperbaric chamber treatment. This patient remained in a mild coma for six months following surgery. Case 3 developed consciousness disturbances, gradually went into a coma following surgery, and died due to pulmonary infection. Central pontine myelinolysis is a severe complication in patients following living donor liver transplantation. Large-dose gamma globulin treatment, as well as hyperbaric oxygen, might be effective therapeutic methods.
authors.affiliation: Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. zhangzhongwei1@medmail.com.cn
authors.forename: Zhong-Wei
authors.initials: ZW
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Kang
authors.forename: Li-Jing
authors.initials: LJ
authors.lastname: Deng
authors.forename: Chuan-Xing
authors.initials: CX
authors.lastname: Luo
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.forename: Xin-Sheng
authors.initials: XS
authors.lastname: Xue
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.forename: Wan-Hong
authors.initials: WH
authors.lastname: Yin
mesh_terms: D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007010:Hyponatremia / Q000150:complications; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy
chemical_list: D007166:Immunosuppressive Agents
references.citation: Transplantation. 1996 Feb 27;61(4):658-61
references.pmid: 8610399
references.citation: Eur Neurol. 2002;47(1):3-10
references.pmid: 11803185
references.citation: Theor Med. 1997 Sep;18(3):221-36
references.pmid: 9271915
references.citation: Am J Physiol. 1985 May;248(5 Pt 2):F711-9
references.pmid: 3993796
references.citation: Clin Neuropharmacol. 2000 Mar-Apr;23(2):110-3
references.pmid: 10803802
references.citation: Clin Transplant. 1998 Jun;12(3):263-9
references.pmid: 9642521
references.citation: Transplantation. 1998 Dec 27;66(12):1596-604
references.pmid: 9884245
references.citation: World J Gastroenterol. 2004 Sep 1;10(17):2540-3
references.pmid: 15300900
references.citation: Arch Neurol. 1987 Jun;44(6):671-3
references.pmid: 3579689
references.citation: J Neurol Sci. 2005 Oct 15;237(1-2):103-6
references.pmid: 15975595
references.citation: Transplant Proc. 1996 Jun;28(3):1674-5
references.pmid: 8658834
references.citation: J Clin Pathol. 1991 Nov;44(11):909-14
references.pmid: 1752981
references.citation: Transplant Proc. 2000 Nov;32(7):2215-6
references.pmid: 11120138