Hepatorenal syndrome, hepatopulmonary syndrome,

nighthawk

LIVER TRANSPLANTATION
September 2003 . Volume 9 . Number 9
Liver Transplantation Worldwide

Hepatorenal syndrome, hepatopulmonary syndrome, and now, hepatospinal
syndrome?

Vincent G. Bain, MD
University of Alberta Liver Unit, 205.22, 8215-112 St, Edmonton, Alberta,
Canada T6G 2C8


   Abstract
Background & Aims: Hepatic myelopathy is a rare complication of chronic
liver disease, causing progressive spastic paraparesis. Today, no therapy of
this disorder has been established. Commonly used therapeutic strategies for
hepatic encephalopathy aiming at the reduction of plasma ammonia levels such
as protein restriction, oral neomycin, lactulose, or ornithine aspartate
fail to improve the symptoms of hepatic myelopathy. The aim of this study
was to find out whether orthotopic liver transplantation (OLT) may improve
hepatic myelopathy. Methods: Follow-up examinations of 3 patients with
severe hepatic myelopathy before and after OLT. Results: In all 3 patients,
the neurologic status improved significantly after liver transplantation.
The grade of improvement was related to the time interval between onset of
the first symptoms of hepatic myelopathy and liver transplantation.
Conclusions: Early recognition of hepatic myelopathy is important because
timely liver transplantation as an established therapy for end-stage liver
disease offers the chance of complete recovery from hepatic paraparesis.
(Gastroenterology 2003;124:346-351.)

   Publishing and Reprint Information
Liver transplantation improves hepatic myelopathy: Evidence by three cases.
Weissenborn K, Tietge UJ, Bokemeyer M, Mohammadi B, Bode U, Manns MP,
Caselitz M. Gastroenterology 2003;124:346-351. (Copyright 2003, reprinted
with permission from "The American Gastroenterological Association".)