Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Aug 21, 2009; 15(31): 3960-3963
Published online Aug 21, 2009. doi: 10.3748/wjg.15.3960
Therapy of central pontine myelinolysis following living donor liver transplantation: Report of three cases
Zhong-Wei Zhang, Yan Kang, Li-Jing Deng, Chuan-Xing Luo, Yan Zhou, Xin-Sheng Xue, Dong Wang, Wan-Hong Yin
Zhong-Wei Zhang, Yan Kang, Li-Jing Deng, Chuan-Xing Luo, Yan Zhou, Xin-Sheng Xue, Dong Wang, Wan-Hong Yin, Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang ZW, Kang Y designed and performed the research; Zhang ZW, Deng LJ, Luo CX, Zhou Y wrote the manuscript; Xue XS, Wang D, Yin WH provided the relevant clinical data.
Correspondence to: Dr. Zhong-Wei Zhang, Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. zhangzhongwei1@medmail.com.cn
Telephone: +86-28-85422471
Fax: +86-28-85422471
Received: June 27, 2009
Revised: July 17, 2009
Accepted: July 24, 2009
Published online: August 21, 2009
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.

Keywords: Cyclosporine; Hyponatremia; Liver transplantation; Myelinolysis; Pontine