Therapy of central pontine myelinolysis following living donor liver transplantation: Report of three cases.
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.
Zhang
Zhong-Wei
ZW
Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. zhangzhongwei1@medmail.com.cn
Kang
Yan
Y
Deng
Li-Jing
LJ
Luo
Chuan-Xing
CX
Zhou
Yan
Y
Xue
Xin-Sheng
XS
Wang
Dong
D
Yin
Wan-Hong
WH
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
D007166:Immunosuppressive Agents
Transplantation. 1996 Feb 27;61(4):658-61
8610399
Eur Neurol. 2002;47(1):3-10
11803185
Theor Med. 1997 Sep;18(3):221-36
9271915
Am J Physiol. 1985 May;248(5 Pt 2):F711-9
3993796
Clin Neuropharmacol. 2000 Mar-Apr;23(2):110-3
10803802
Clin Transplant. 1998 Jun;12(3):263-9
9642521
Transplantation. 1998 Dec 27;66(12):1596-604
9884245
World J Gastroenterol. 2004 Sep 1;10(17):2540-3
15300900
Arch Neurol. 1987 Jun;44(6):671-3
3579689
J Neurol Sci. 2005 Oct 15;237(1-2):103-6
15975595
Transplant Proc. 1996 Jun;28(3):1674-5
8658834
J Clin Pathol. 1991 Nov;44(11):909-14
1752981
Transplant Proc. 2000 Nov;32(7):2215-6
11120138