title: Neurologic complications in adult living donor liver transplant patients: an underestimated factor?
abstract: Liver transplantation is the only curative treatment in patients with end-stage liver disease. Neurological complications (NC) are increasingly reported to occur in patients after cadaveric liver transplantation. This retrospective cohort study aims to evaluate the incidence and causes of NC in living donor liver transplant (LDLT) patients in our transplant center. Between August 1998 and December 2005, 121 adult LDLT patients were recruited into our study. 17% of patients experienced NC, and it occurred significantly more frequently in patients with alcoholic cirrhosis (42%) and autoimmune hepatitis (43%) as compared with patients with hepatitis B or C (9/10%, P = 0.013). The most common NC was encephalopathy (47.6%) followed by seizures (9.5%). The choice of immunosuppression by calcineurin inhibitor (Tacrolimus or Cyclosporin A) showed no significant difference in the incidence of NC (19 vs. 17%). The occurrence of NC did not influence the clinical outcome, since mortality rate, median ICU stay and length of hospital stay were similar between the two groups. Most patients who survived showed a nearly complete recovery of their NC. NCs occur in approximately 1 in 6 patients after LDLT and seem to be predominantly transient in nature, without major impact on clinical outcome.
authors.affiliation: Department of General-, Visceral- and Transplant Surgery, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany. fuat.saner@uni-due.de
authors.forename: Fuat Hakan
authors.initials: FH
authors.lastname: Saner
authors.forename: Julia
authors.initials: J
authors.lastname: Gensicke
authors.forename: Steven W M
authors.initials: SW
authors.lastname: Olde Damink
authors.forename: Goran
authors.initials: G
authors.lastname: Pavlaković
authors.forename: Juergen
authors.initials: J
authors.lastname: Treckmann
authors.forename: Marc
authors.initials: M
authors.lastname: Dammann
authors.forename: Gernot M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: Georgios C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: Arnold
authors.initials: A
authors.lastname: Radtke
authors.forename: Susanne
authors.initials: S
authors.lastname: Koeppen
authors.forename: Susanne
authors.initials: S
authors.lastname: Beckebaum
authors.forename: Vito
authors.initials: V
authors.lastname: Cicinnati
authors.forename: Silvio
authors.initials: S
authors.lastname: Nadalin
authors.forename: Massimo
authors.initials: M
authors.lastname: Malagó
authors.forename: Andreas
authors.initials: A
authors.lastname: Paul
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D001927:Brain Diseases / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000601:surgery; D006526:Hepatitis C / Q000188:drug therapy / Q000601:surgery; D019693:Hepatitis, Autoimmune / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008104:Liver Cirrhosis, Alcoholic / Q000188:drug therapy / Q000601:surgery; D008107:Liver Diseases / Q000188:drug therapy / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus