Abstract
A 45-year-old man underwent heart transplantation due to dilated cardiomyopathy. Cyclosporine, 2 mg/kg per day, was intravenously givell postoperatively. As central neurotoxicity signs that were included pin-point pupil, no light reflex, coma, were presented at 8 postoperative hours, cyclosporine was decreased to 1 mg/kg er day. At that time the cyclosporine level was 345 $\mu\textrm{g}$/L, the serum creatinine level was 1.8mg/dl and the serum magnesium level was within normal limit. He awaked at 31 postoperative hours and all sign of cyclosporine-induced central neurotoxicity was resolved after postoperative days. He was discharged without sequale at postoperative day 28.
승모판막 폐쇄부전증으로 승모판막 치환술을 받은 45세 남자가 확장성 심근증으로 심장이식수술을 받았다. 환자는 수술전 면역억제를 위하여 cyclosporine 400 mg, Immuran 250 mg과 Solumedrol 500 mg을 투약하였 다 술후 cyclosporine을 2 mg/kg/day로 정주했는데 술후 8시간이 지나도 혼수상태가 지속되어 cyclosporine을 1 mg/kg/day로 감량하였다. 당시 혈장내 cyclosporine농도는 345$\mu\textrm{g}$/L, 크레아티닌 수치는 1.8 mg/dl였으며 마그 네슘 수치는 정상수준이 였다. 환자의 의식은 술후 31시간째 완전히 회복되었으나 술후 36시간경부터 전신근 력약화, 초조감, 환청 및 환각을 호소하였다. 신경증상들은 술후 4일째 정상으로 회복되었으며, 환자는 술후 28일째 퇴원하였고 12개월째 후유증은 보이지 않고 있다.
