Department Team Publishes Case Series on Managing Severe Hyponatremia During Liver Transplant Surgery
We are proud to share that a multidisciplinary team from the Department of Anesthesiology has published a case series in the December issue of Transplant Proceedings highlighting innovative intraoperative management of severe hyponatremia during orthotopic liver transplant surgery.
The article, “Intraoperative Management of Severe Hyponatremia During Orthotopic Liver Transplant Surgery: Case Series,” was authored entirely by members of our department—reflecting the depth of expertise, collaboration, and shared commitment to advancing patient care through scholarship.
A High-Risk Clinical Challenge
Severe hyponatremia is a common and serious condition in patients with end-stage liver disease. Correcting sodium levels too rapidly—particularly in the setting of complex transplant surgery—can lead to osmotic demyelination syndrome, a devastating and potentially fatal neurologic complication.
Liver transplantation presents unique challenges for sodium management. Massive transfusion, rapid fluid shifts, and physiologic stress can all cause abrupt changes in serum sodium levels, making careful intraoperative control essential—but difficult.
Innovation Through Collaboration
In this case series, the team describes two liver transplant recipients with severe to profound hyponatremia who were successfully managed intraoperatively using continuous veno-venous hemodialysis (CVVHD) with specially modified dialysate. This approach allowed for precise, controlled correction of sodium levels during surgery—mitigating neurologic risk while supporting complex operative care.
The success of these cases reflects close coordination among anesthesiologists, transplant teams, and perioperative specialists—demonstrating how thoughtful planning and interdisciplinary teamwork can translate into safer outcomes for high-risk patients.
Collaboration Driving Safer Transplant Care
This publication underscores the strength of department-led collaboration, where clinical insight, technical expertise, and shared problem-solving come together to address some of the most challenging scenarios in perioperative medicine.
The authors include:
Jacob E. Pollard, Alexander A. Vitin, Charles E. Galaviz, H. Cameron Norris, Evelyn C. Loose, Jacob B. Brandenburg, Wendell H. Williams, F. Arran Seiler, Bianca E. Rich, Maegan R. Tupinio, and Claire M. Lu.
We congratulate the entire team on this important contribution to transplant anesthesiology and for exemplifying how collaborative care drives meaningful clinical innovation!