Pontine and extrapontine myelinolysis following liver transplantation: Relationship to serum sodium

Zbigniew K. Wszolek, Rodney D. McComb, Ronald Pfeiffer, Robert E. Steg, R. Patrick Wood, Byers W. Shaw, Rodney S. Markin

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

The relationship between central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) and serum sodium changes in the setting of orthotopic liver transplantation (OLT) is examined. Postmortem examination of 14 patients with end-stage liver disease who underwent liver transplantation revealed CPM in four, of which three also had EPM. A retrospective review of clinical and laboratory data was performed on all patients. There were marked perioperative rises (21-32 mEq/L) in the serum sodium concentration in all four patients who developed myelinolysis. In contrast, the largest increase in sodium in patients without demyelination was 16 mEq/L. We conclude that perioperative rises in the serum sodium concentration increase the risk of myelinolysis. CPM and EPM should be considered if the patient develops mental status changes or focal neurological deficits several days after OLT.

Original languageEnglish (US)
Pages (from-to)1006-1012
Number of pages7
JournalTransplantation
Volume48
Issue number6
StatePublished - 1989
Externally publishedYes

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Central Pontine Myelinolysis
Liver Transplantation
Sodium
Serum
End Stage Liver Disease
Mentally Ill Persons
Demyelinating Diseases
Autopsy

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Wszolek, Z. K., McComb, R. D., Pfeiffer, R., Steg, R. E., Wood, R. P., Shaw, B. W., & Markin, R. S. (1989). Pontine and extrapontine myelinolysis following liver transplantation: Relationship to serum sodium. Transplantation, 48(6), 1006-1012.

Pontine and extrapontine myelinolysis following liver transplantation : Relationship to serum sodium. / Wszolek, Zbigniew K.; McComb, Rodney D.; Pfeiffer, Ronald; Steg, Robert E.; Wood, R. Patrick; Shaw, Byers W.; Markin, Rodney S.

In: Transplantation, Vol. 48, No. 6, 1989, p. 1006-1012.

Research output: Contribution to journalArticle

Wszolek, ZK, McComb, RD, Pfeiffer, R, Steg, RE, Wood, RP, Shaw, BW & Markin, RS 1989, 'Pontine and extrapontine myelinolysis following liver transplantation: Relationship to serum sodium', Transplantation, vol. 48, no. 6, pp. 1006-1012.
Wszolek, Zbigniew K. ; McComb, Rodney D. ; Pfeiffer, Ronald ; Steg, Robert E. ; Wood, R. Patrick ; Shaw, Byers W. ; Markin, Rodney S. / Pontine and extrapontine myelinolysis following liver transplantation : Relationship to serum sodium. In: Transplantation. 1989 ; Vol. 48, No. 6. pp. 1006-1012.
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AU - Wood, R. Patrick

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