[Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the Centro de Investigaciones Médico Quirúrgicas in Cuba].
BACKGROUND
Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8 47% of those reported. AIMS. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate.


METHODS
From the medical records of 26 patients who received LT at the CIMEQ (July 1999 December 2001), we collected a group of variables related to the donor, the surgical procedure and the post operative period and associated them to the occurrence of NC while these patients were in the ICU.


RESULTS
NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041).


CONCLUSIONS
NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post operative period.
Abdo-Cuza
A
A
Centro de Investigaciones Médico Quirúrgicas (CIMEQ), La Habana, Cuba. bcimeq@infomed.sld.cu
González-Rapado
L
L
López-Cruz
O
O
Pérez-Bernal
J
J
Castellanos-Gutiérrez
R
R
Gómez-Peyre
F
F
Hinojosa-Pérez
R
R
Lage-Dávila
J
J
Alvarez-Rodríguez
A
A
Fernández-Valle
A
A
Fernández-Maderos
I
I
Samada-Suárez
M
M
Hernández-Perera
J C
JC
Bernardos-Rodríguez
A
A
D000293:Adolescent; D000328:Adult; D003462:Cuba; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*; D009483:Neuropsychological Tests; D011183:Postoperative Complications; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies