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Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series

Background: Hyperammonemia after lung transplantation (HALT) is a rare but serious complication with high mortality. This systematic review delineates possible etiologies of HALT and highlights successful strategies used to manage this fatal complication. Methods: Seven biomedical databases and grey...

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Autores principales: Kamel, Amir Y., Emtiazjoo, Amir M., Adkins, Lauren, Shahmohammadi, Abbas, Alnuaimat, Hassan, Pelaez, Andres, Machuca, Tiago, Pipkin, Mauricio, Lee, Hyun-wook, Weiner, I. David, Chandrashekaran, Satish
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128545/
https://www.ncbi.nlm.nih.gov/pubmed/35620675
http://dx.doi.org/10.3389/ti.2022.10433
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author Kamel, Amir Y.
Emtiazjoo, Amir M.
Adkins, Lauren
Shahmohammadi, Abbas
Alnuaimat, Hassan
Pelaez, Andres
Machuca, Tiago
Pipkin, Mauricio
Lee, Hyun-wook
Weiner, I. David
Chandrashekaran, Satish
author_facet Kamel, Amir Y.
Emtiazjoo, Amir M.
Adkins, Lauren
Shahmohammadi, Abbas
Alnuaimat, Hassan
Pelaez, Andres
Machuca, Tiago
Pipkin, Mauricio
Lee, Hyun-wook
Weiner, I. David
Chandrashekaran, Satish
author_sort Kamel, Amir Y.
collection PubMed
description Background: Hyperammonemia after lung transplantation (HALT) is a rare but serious complication with high mortality. This systematic review delineates possible etiologies of HALT and highlights successful strategies used to manage this fatal complication. Methods: Seven biomedical databases and grey literature sources were searched using keywords relevant to hyperammonemia and lung transplantation for publications between 1995 and 2020. Additionally, we retrospectively analyzed HALT cases managed at our institution between January 2016 and August 2018. Results: The systematic review resulted in 18 studies with 40 individual cases. The mean peak ammonia level was 769 μmol/L at a mean of 14.1 days post-transplant. The mortality due to HALT was 57.5%. In our cohort of 120 lung transplants performed, four cases of HALT were identified. The mean peak ammonia level was 180.5 μmol/L at a mean of 11 days after transplantation. HALT in all four patients was successfully treated using a multimodal approach with an overall mortality of 25%. Conclusion: The incidence of HALT (3.3%) in our institution is comparable to prior reports. Nonetheless, ammonia levels in our cohort were not as high as previously reported and peaked earlier. We attributed these significant differences to early recognition and prompt institution of multimodal treatment approach.
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spelling pubmed-91285452022-05-25 Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series Kamel, Amir Y. Emtiazjoo, Amir M. Adkins, Lauren Shahmohammadi, Abbas Alnuaimat, Hassan Pelaez, Andres Machuca, Tiago Pipkin, Mauricio Lee, Hyun-wook Weiner, I. David Chandrashekaran, Satish Transpl Int Health Archive Background: Hyperammonemia after lung transplantation (HALT) is a rare but serious complication with high mortality. This systematic review delineates possible etiologies of HALT and highlights successful strategies used to manage this fatal complication. Methods: Seven biomedical databases and grey literature sources were searched using keywords relevant to hyperammonemia and lung transplantation for publications between 1995 and 2020. Additionally, we retrospectively analyzed HALT cases managed at our institution between January 2016 and August 2018. Results: The systematic review resulted in 18 studies with 40 individual cases. The mean peak ammonia level was 769 μmol/L at a mean of 14.1 days post-transplant. The mortality due to HALT was 57.5%. In our cohort of 120 lung transplants performed, four cases of HALT were identified. The mean peak ammonia level was 180.5 μmol/L at a mean of 11 days after transplantation. HALT in all four patients was successfully treated using a multimodal approach with an overall mortality of 25%. Conclusion: The incidence of HALT (3.3%) in our institution is comparable to prior reports. Nonetheless, ammonia levels in our cohort were not as high as previously reported and peaked earlier. We attributed these significant differences to early recognition and prompt institution of multimodal treatment approach. Frontiers Media S.A. 2022-05-03 /pmc/articles/PMC9128545/ /pubmed/35620675 http://dx.doi.org/10.3389/ti.2022.10433 Text en Copyright © 2022 Kamel, Emtiazjoo, Adkins, Shahmohammadi, Alnuaimat, Pelaez, Machuca, Pipkin, Lee, Weiner and Chandrashekaran. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Kamel, Amir Y.
Emtiazjoo, Amir M.
Adkins, Lauren
Shahmohammadi, Abbas
Alnuaimat, Hassan
Pelaez, Andres
Machuca, Tiago
Pipkin, Mauricio
Lee, Hyun-wook
Weiner, I. David
Chandrashekaran, Satish
Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title_full Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title_fullStr Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title_full_unstemmed Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title_short Hyperammonemia After Lung Transplantation: Systematic Review and a Mini Case Series
title_sort hyperammonemia after lung transplantation: systematic review and a mini case series
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128545/
https://www.ncbi.nlm.nih.gov/pubmed/35620675
http://dx.doi.org/10.3389/ti.2022.10433
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