Retrospective analysis of central pontine and extrapontine myelinolysis after liver transplantation in China

Objective To investigate the causes,clinical manifestation,treatment,and prognosis of central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM) after liver transplantation.Methods The databases of CNKI,Wanfang and PubMed were searched for 2000-2011 published articles on CPM and EPM.Data were extracted by using a standardized form and a retrospective clinical analysis was performed.Results Forty-four patients reported by 12 liver transplantation centers in mainland China were enrolled into this analysis.Perioperative rapid correction of sodium and preoperative history of hepatic encephalopathy accounted for 77.4% and 45.2% of the total,respectively.Both events were related to the time of symptom onset(P0.05).Postoperative infection and renal failure were 71.0% and 38.7%,and both were associated with clinical outcomes(P0.05).Conclusion Perioperative excessive sodium correction and preoperative hepatic encephalopathy may be causes of myelinolysis after liver transplantation.The presence of complications was associated with a poor prognosis of patients,which should be paid more attention by clinicians.