Severe neurological events following liver transplantation.
BACKGROUND
Problems related to the central nervous system may have major impact on morbidity and mortality. The aim of this retrospective study was to evaluate the nature and incidence of serious neurologic events in patients following liver transplantation.


METHODS
Between January 2001 and May 2004, 168 patients (105 female, 63 male) requiring transplantation for alcoholic cirrhosis, hepatitis B and C, and acute liver failure were admitted to the Intensive Care Unit (ICU) of University Hospital Essen after liver transplantation. We identified the reason for the neurologic events, the underlying disease, type of immunosuppression, and the survival rate.


RESULTS
Severe neurologic events occurred in 46 (27.3%) of the patients. The length of stay of these patients in the ICU (18.4 +/- 19.7 days) was longer in comparison to the total patients (8.3 +/- 9.5 days, p < 0.05). The most common neurological complications were encephalopathy (18.5%) and seizures (5.4%). The survival rate after liver transplantation with neurological events was lower compared to patients without, but not significantly different (73.9 vs. 79.5%). The calcineurin inhibitor used had no impact on neurological events [cyclosporine (25.5%); tacrolimus (32.5%)].


CONCLUSIONS
There was a high incidence of serious neurologic events after liver transplantation. The major neurologic manifestation in our patients was encephalopathy followed by seizures.
Saner
Fuat Hakan
FH
Department of General Surgery and Transplantation, University Hospital Essen, Essen, Germany. fuat.saner@uni-essen.de
Sotiropoulos
Georgious C
GC
Gu
Yanli
Y
Paul
Andreas
A
Radtke
Arnold
A
Gensicke
Julia
J
Kavuk
Ilker
I
Malagó
Massimo
M
Broelsch
Christoph E
CE
D000328:Adult; D001927:Brain Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus