title: [State of lucid delirium after orthotopic liver transplantation. Clinical case].
abstract: Neuropsychiatric complications after liver transplantation are common and have an incidence ranging from 0.5% to 47% in several international reports. They are due to different causes (coagulation, haemodynamic or electrolyte disorders, infections, immunosuppressive drugs). In patients receiving cyclosporin and tacrolimus, headache, tremors, dysarthria, seizures and delirium are the most common disorders and are not always related to toxic drug concentrations or overdosage. We report the case of a liver transplant patient receiving cyclosporin who presented a state of lucid delirium with a mystic persecutory content. in the first few postoperative days. Cyclosporin was withdrawn and the patient switched to tacrolimus, initially combined with chlorpromazine and later with clotiapine. She rapidly improved and recovered completely within a few days. At follow-up the patient is doing well and can remember the episode of delirium perfectly well. Psychiatric evaluation preoperatively and during follow-up is important to recognize and treat these complications, which can prevent the full recovery of transplanted patients and also increase the cost of this procedure.
authors.affiliation: Dipartimento d'Emergenza e Trapianti d'Organo, Sez. Chirurgia Generale e Trapianto di Fegato, Policlinico, Piazza G. Cesare, 11, 70124 Bari.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Volpi
authors.forename: Annunziata
authors.initials: A
authors.lastname: Panebianco
authors.forename: Oronzo C
authors.initials: OC
authors.lastname: Pannarale
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ricci
authors.forename: Ilario
authors.initials: I
authors.lastname: Precchiazzi
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Caputi-Iambrenghi
authors.forename: Felice
authors.initials: F
authors.lastname: Vadruccio
authors.forename: Luigi G
authors.initials: LG
authors.lastname: Lupo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Memeo
mesh_terms: D016572:Cyclosporine / Q000009:adverse effects*; D003693:Delirium / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016031:Liver Transplantation; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine