[Major neurological complications following liver transplantation and their management].
OBJECTIVE
To study the clinical features, underlying mechanism and management of major neurological complications following liver transplantation.


METHODS
The data of 467 patients undergoing liver transplantation from Oct. 2003 to Sep. 2005 were retrospectively reviewed.


RESULTS
Neurological complications occurred in 91 (19.49%) cases. The most common neurological complications were encephalopathy (72 cases), followed by stroke (12 cases), seizure (4 cases), central pontine myelinolysis (3 cases), and central nervous system infections (2 cases). Five encephalopathy cases were treated with continuous renal replacement and 5 intracranial hemorrhage cases with neurosurgical intervention. The mortality related to neurological complications was 10.98% (12/91).


CONCLUSIONS
Neurological complications are common and potentially fatal following liver transplantation involving several factors. CsA and FK506 may play an important role in the onset of neurological complications, and stroke, especially intracranial hemorrhage, has a high mortality. Combined therapies and timely modulation of the immunosuppressive regimens may improve the patient's outcome.
Yi
Shu-hong
SH
Liver Transplantation Center, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Li
Hua
H
Yang
Yang
Y
Lu
Min-qiang
MQ
Cai
Chang-jie
CJ
Xu
Chi
C
Yi
Hui-min
HM
Wang
Gen-shu
GS
Chen
Gui-hua
GH
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology* / Q000628:therapy*; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors