• Eun Mi Lee, Joong Koo Kang, Sung-Cheol Yun, Ki-Hun Kim, Sang Joon Kim, Kyu-Sam Hwang, and Sung-Gyu Lee.
• Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
• Eur. Neurol. 2009 Jan 1;62(6):362-8.

BackgroundCentral pontine myelinolysis (CPM)/extrapontine myelinolysis (EPM) is one of the most serious neurological complications that can occur after orthotopic liver transplantation (OLT). We analyzed the risk factors for CPM/EPM in OLT patients.MethodsWe retrospectively reviewed the records of 1,247 patients who underwent OLT between 1992 and 2005. We compared demographic, clinical and biological parameters of patients with CPM/EPM with those of age-, sex- and operation date-matched patients without CPM/EPM (controls).ResultsOf 1,247 patients, 11 (0.88%) were diagnosed with CPM/EPM based on neuroimaging findings. A higher Model for End-Stage Liver Disease-Na score, preoperative hyponatremia and hypocholesterolemia, as well as greater changes in electrolytes, especially sodium, during surgery, were observed in the CPM/EPM group (p < 0.05).ConclusionCPM/EPM after OLT is more likely to occur in patients with more severe preoperative liver dysfunction and greater changes in electrolyte imbalance, especially sodium, during surgery.

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