title: Neuropsychiatric complications after liver transplantation: role of immunosuppression and hepatitis C.
abstract: Neuropsychiatric complications are an important source of morbidity following orthotopic liver transplantation. Etiology of liver disease and type of immunosuppression are possible related factors. The aim of this study was to describe the prevalence of neuropsychiatric complications after liver transplantation, the role of immunosuppression, and the association between these and specific liver diseases such as hepatitis C. One hundred twenty-eight patients with liver transplants were studied. Tacrolimus was the primary immunosuppressant in 101 patients and cyclosporine in 27 patients. Seventy-five complications in 49 patients (38.2%) were reported. In 43 patients, the etiology was associated with immunosuppression: 36 on tacrolimus and 7 on cyclosporine (P = 0.34). Seventeen and four-tenths percent of patients with hepatitis C and 4.6% of patients without hepatitis C developed depression (P = 0.02). There is no difference between types of primary immunosuppression and neuropsychiatric complications. There is a significantly greater incidence of depression in patients transplanted for hepatitis C.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA. ctombazzi@utmem.edu
authors.forename: Claudio R
authors.initials: CR
authors.lastname: Tombazzi
authors.forename: Bradford
authors.initials: B
authors.lastname: Waters
authors.forename: M Hosein
authors.initials: MH
authors.lastname: Shokouh-Amiri
authors.forename: Santiago R
authors.initials: SR
authors.lastname: Vera
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Riely
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D003866:Depressive Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000601:surgery*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D015994:Incidence; D008107:Liver Diseases / Q000601:surgery; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects; D013714:Tennessee / Q000453:epidemiology
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus