title: [The possible causes of serious central nervous system complications occurring after liver transplantation].
abstract: OBJECTIVE
  To study the classification, possible causes, cure and prevention measures of serious central nervous system (CNS) complications occurring early following liver transplantation.
  
  
  METHODS
  The clinical material records of 347 patients undergoing the orthotopic liver transplantation from July 2001 to July 2006 were analyzed retrospectively. The perioperation risk factors of CNS complications, which might be the primary liver disease, serum sodium level, magnesium level, fluctuation degree of plasma osmolality and serum sodium, function of blood clotting, etc. , were analyzed between patients with serious CNS complications and without neurological complications.
  
  
  RESULTS
  A total of 71 (20. 46%) neurological symptoms appeared in 347 postoperative patients who included 6 cases (1. 73%) with serious CNS complications such as cerebral edema, cerebral hemorrhage and central pontine myelinolysis, and of 6 cases, 5 patients died. The morbidity of early serious complications of CNS was higher in patients with decompensate cirrhosis and/or hypersplenism. Compared with the group of no neurological complications, two patients with cerebral hemorrhage suffered from preoperative hypersplenism and worse dysfunction of blood clotting (P<0. 05); patients with developed CPM and cerebral oedema had serious hyponatremia history before operation, and intensely fluctuated plasma osmolality showed before and after operation.
  
  
  CONCLUSIONS
  The onset of serious complications of CNS in recipients of liver transplantation may be intimately related to the primary liver disease, and be associated with chronic hyponatremia, rapid correction of serum sodium concentration, intense increase of plasma osmolality and no prompt rectification of the function of blood clotting during perioperation.
authors.affiliation: Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Fu-qiang
authors.initials: FQ
authors.lastname: Li
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Lü-nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
authors.forename: Tian-fu
authors.initials: TF
authors.lastname: Wen
authors.forename: Ji-chun
authors.initials: JC
authors.lastname: Zhao
authors.forename: Zhong-wei
authors.initials: ZW
authors.lastname: Zhang
authors.forename: Xiao-long
authors.initials: XL
authors.lastname: Liu
authors.forename: Meng
authors.initials: M
authors.lastname: Yang
authors.forename: Guang-tan
authors.initials: GT
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult