Hyperammonemia and Ornithine Transcarbamylase Deficiency after Bariatric Surgery: A Retrospective Study

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dc.contributor.authorPardo Lameda, Ivanesa L.en
dc.contributor.authorWang, Eugeneen
dc.contributor.authorSharbaugh, Matthewen
dc.contributor.authorLovette, Anyeaen
dc.contributor.authorShope, Timothy R.en
dc.contributor.authorKoch, Timothy R.en
dc.date.accessioned2024-12-02T15:01:18Zen
dc.date.available2024-12-02T15:01:18Zen
dc.date.issued2024-07-17en
dc.description.abstractBackground: The number of bariatric surgeries has risen in the past decades. Hyperammonemia related to ornithine transcarbamylase (OTC) deficiency is a potentially lethal disorder in patients with neurological symptoms. The apparent prevalence of OTC deficiency and potential predictors of mortality was examined in patients after bariatric surgery. Methods: This is a retrospective study of postoperative patients who developed hyperammonemia in a large, urban teaching hospital. Urinary orotic acid levels were ordered in individuals with elevated plasma ammonia. Results: Between January 2012 and August 2017, 1597 bariatric surgical procedures were performed. Seven women hospitalized with consistent symptoms had a mean peak plasma ammonia level of 155 umol/L (range: 57 to 273) and mean urinary orotic acid excretion of 3.3 mmol/mol creatinine (range: 1.6–7.9) after vertical sleeve gastrectomy, duodenal switch, or gastric bypass surgery, and there were four mortalities (57%). The apparent postoperative prevalence of OTC deficiency is 0.31%. Peak lactic acid (p = 0.011) level is a predictor of mortality. Conclusions: Hyperammonemia is associated with a high mortality rate predicted by high lactic acid levels. Postoperative prevalence of OTC deficiency is higher than the general population. Further investigations should examine potential mechanisms for its development.en
dc.description.versionAccepted versionen
dc.format.extent5 page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1089/bari.2023.0057en
dc.identifier.eissn2168-0248en
dc.identifier.issn2168-023Xen
dc.identifier.orcidKoch, Timothy [0000-0002-8026-9653]en
dc.identifier.urihttps://hdl.handle.net/10919/123669en
dc.language.isoenen
dc.publisherMary Ann Lieberten
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectornithine carbamoyltransferase deficiency diseaseen
dc.subjecthyperammonemiaen
dc.subjectbariatric surgeryen
dc.subjectobesityen
dc.subjectgastric bypassen
dc.titleHyperammonemia and Ornithine Transcarbamylase Deficiency after Bariatric Surgery: A Retrospective Studyen
dc.title.serialBariatric Surgical Practice and Patient Careen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dc.type.otherEarly Accessen
dc.type.otherJournalen
pubs.organisational-groupVirginia Techen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-groupVirginia Tech/VT Carilion School of Medicine/Internal Medicine/General IMen

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