Fatal hyperammonemia after orthotopic lung transplantation.
Publication/Presentation Date
2-15-2000
Abstract
BACKGROUND: A case of fatal hyperammonemia complicating orthotopic lung transplantation was previously reported.
OBJECTIVE: To describe the incidence, clinical features, and treatment of hyperammonemia associated with orthotopic lung transplantation.
DESIGN: Retrospective cohort analysis.
SETTING: Academic medical center and lung transplantation center in Philadelphia, Pennsylvania.
PATIENTS: 145 sequential adult patients who underwent orthotopic lung transplantation.
MEASUREMENTS: Plasma ammonium levels.
RESULTS: Six of the 145 patients who had had orthotopic lung transplantation developed hyperammonemia, all within the first 26 days after transplantation. The 30-day post-transplantation mortality rate was 67% for patients with hyperammonemia compared with 17% for those without hyperammonemia (P = 0.01). Development of major gastrointestinal complications (P = 0.03), use of total parenteral nutrition (P < 0.001), and lung transplantation for primary pulmonary hypertension (P = 0.045) were associated with hyperammonemia.
CONCLUSIONS: Hyperammonemia is a potentially fatal event occurring after orthotopic lung transplantation. It is associated with high nitrogen load, concurrent medical stressors, primary pulmonary hypertension, and hepatic glutamine synthetase deficiency.
Volume
132
Issue
4
First Page
283
Last Page
287
ISSN
0003-4819
Published In/Presented At
Lichtenstein, G. R., Yang, Y. X., Nunes, F. A., Lewis, J. D., Tuchman, M., Tino, G., Kaiser, L. R., Palevsky, H. I., Kotloff, R. M., Furth, E. E., Bavaria, J. E., Stecker, M. M., Kaplan, P., & Berry, G. T. (2000). Fatal hyperammonemia after orthotopic lung transplantation. Annals of internal medicine, 132(4), 283–287. https://doi.org/10.7326/0003-4819-132-4-200002150-00006
Disciplines
Medicine and Health Sciences
PubMedID
10681283
Department(s)
Department of Surgery
Document Type
Article