Symptomatic hyperammonemia after lung transplantation: Lessons learnt

Siddiq Anwar, Diptesh Gupta, Muhammad A. Ashraf, Syed A. Khalid, Syed M. Rizvi, Brent W. Miller, Daniel C. Brennan

Research output: Contribution to journalArticle

Abstract

Hyperammonemia, post-orthotopic lung transplantation, is a rare but mostly fatal complication. Various therapies, including those to decrease ammonia generation, increase nitrogen excretion, and several dialytic methods for removing ammonia have been tried. We describe three lung transplant recipients who developed acute hyperammonemia early after transplantation. Two of the three patients survived after a multidisciplinary approach including discontinuation of drugs, which impair urea cycle, aggressive ammonia reduction with prolonged daily intermittent hemodialysis (HD), and overnight slow low-efficiency dialysis in conjunction with early weaning of steroids and other therapeutic measures. Our experience suggests that early initiation of dialysis, high dialysis dose, increased frequency, and HD preferably to less efficient modalities increases survival in these patients.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalHemodialysis International
Volume18
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Keywords

  • Dialysis
  • Hyperammonemia
  • Lung transplantation
  • Renal replacement therapy

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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  • Cite this

    Anwar, S., Gupta, D., Ashraf, M. A., Khalid, S. A., Rizvi, S. M., Miller, B. W., & Brennan, D. C. (2014). Symptomatic hyperammonemia after lung transplantation: Lessons learnt. Hemodialysis International, 18(1), 185-191. https://doi.org/10.1111/hdi.12088