Document Detail

Rhabdomyolysis after liver transplantation: a case report.
MedLine Citation:
PMID:  18929870     Owner:  NLM     Status:  MEDLINE    
Our aim was to present the case of a pediatric biliary atresia patient who experienced rhabdomyolysis with severe cardiac arrhythmias associated with hyperkalemia, metabolic acidosis, and myoglobulinemia during liver transplantation. A 5-year-old girl, weighing 16.5 kg, with end-stage liver disease due to biliary atresia underwent living donor liver transplantation. A sudden onset of atrial fibrillation with rapid ventricular response was noted during the transplantation. The cardiac arrhythmia was associated with hyperkalemia, metabolic acidosis, and myoglobulinemia. Rhabdomyolysis was suspected. Hyperkalemia and metabolic acidosis were not corrected despite treatment with 10 mL of 50% glucose plus 6 U of regular insulin in 4 succeeding boluses and 110 mEq sodium bicarbonate before sending the patient to the intensive care unit. A corresponding decrease and normalization in serum potassium and correction of metabolic acidosis were noted as responses to a single dose of intravenous (20 mg) dantrolene. The patient was extubated 5 days after transplantation. The kidney function remained within normal limits during the rhabdomyolysis and the entire hospital stay. The patient was discharged 7 weeks later and is surviving with the original liver graft and satisfactory kidney function to date.
C-J Huang; C-L Chen; C-S Wang; K-W Cheng; K-H Chen; C-C Wang; A M Concejero; Y-F Cheng; T-L Huang; K-W Chiu; S-H Wang; C-C Lin; Y-W Liu; B Jawan
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  40     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2821-2     Citation Subset:  IM    
Liver Transplantation Program, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis
Biliary Atresia / surgery*
Child, Preschool
Dantrolene / therapeutic use
Liver Transplantation / adverse effects*
Myoglobin / metabolism
Postoperative Complications
Rhabdomyolysis / diagnosis*,  drug therapy
Tachycardia, Ventricular / drug therapy
Treatment Outcome
Reg. No./Substance:
0/Myoglobin; 7261-97-4/Dantrolene

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