Severe hearing loss after liver transplantation.
Little is known about hearing impairment in patients after organ transplantation. Few cases of hearing loss associated with different immunosuppressants have been published. To evaluate severe hearing impairment in patients after liver transplantation (OLT), all living adult patients in need of a hearing aid were analyzed. Out of 521 transplanted patients, 25 (5%) were identified with hearing aids. Nine (36%) of these patients either suffered from hearing loss prior to OLT or experienced risk factors such as ototoxic drugs. Of the remaining 16 patients who developed severe hearing loss after OLT (64%), half were men. Mean age was 42 +/- 18 years at OLT, which took place 8 +/- 4 years ago. Main transplantation indication was virus-induced cirrhosis (44%). In 14/16 (88%) patients, the hearing aid was bilateral. In 50% of patients, the hearing aid was necessary within 2 years post-OLT. Additional tinnitus was present in 9/16 patients (56%), otalgia in three patients (19%). Four patients (25%) reported a history of sudden deafness. In three of them, an association with high levels of calcineurin inhibitors was found. The proportion of patients receiving tacrolimus (50%) was relatively higher than those receiving cyclosporine (50%) compared to control patients (28% respectively 64%, P < .05). In conclusion, a high incidence of severe hearing loss was found in patients after liver transplantation. In most patients, onset of hearing loss is early and bilateral, suggesting a dose-dependent toxicity. The pathogenetic role of different immunosuppressants remains to be evaluated.
Rifai
K
K
Department of Gastroenterology, Hepatology, and Endocrinology, Medical School Hannover, Hannover, Germany. rifai.k@gmx.de
Bahr
M J
MJ
Cantz
T
T
Klempnauer
J
J
Manns
M P
MP
Strassburg
C P
CP
D000328:Adult; D065095:Calcineurin Inhibitors; D003638:Deafness / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006310:Hearing Aids; D034381:Hearing Loss / Q000139:chemically induced / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D020123:Sirolimus / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D016559:Tacrolimus / Q000009:adverse effects*; D013997:Time Factors
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus