Neurologic complications in adult living donor liver transplant patients: an underestimated factor?
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.
Saner
Fuat Hakan
FH
Department of General-, Visceral- and Transplant Surgery, University Hospital Essen, Hufelandstr. 55, 45122, Essen, Germany. fuat.saner@uni-due.de
Gensicke
Julia
J
Olde Damink
Steven W M
SW
Pavlaković
Goran
G
Treckmann
Juergen
J
Dammann
Marc
M
Kaiser
Gernot M
GM
Sotiropoulos
Georgios C
GC
Radtke
Arnold
A
Koeppen
Susanne
S
Beckebaum
Susanne
S
Cicinnati
Vito
V
Nadalin
Silvio
S
Malagó
Massimo
M
Paul
Andreas
A
Broelsch
Christoph E
CE
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
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus