title: Incidence of abdominal wall numbness post-liver transplantation and its complications.
abstract: Liver transplantation (LTx) is a life-saving procedure for end-stage liver disease. However, LTx remains a major surgical procedure with a significant amount of morbidity and mortality. Several different types of post-LTx complications have been studied and reported; however, the numbness of the abdominal skin between the subcostal incision and the umbilicus and its associated complications have not been studied in a large patient population. The aim of this study was to report the incidence of numbness in the abdominal skin post-LTx and its implications in routine life. One hundred and one post-LTx patients were questioned in the clinic about numbness. There were 52 male patients and 49 female patients with a mean age of 51.9 +/- 11.3 years at the time of LTx, and the mean time from transplant was 35.0 +/- 29.5 months (range, 3-113 months). The implications were recorded. All 101 patients (100%) had an area of numbness between the subcostal incision and the umbilicus. Four of these patients had an area of superficial-to-deep burns from hot food (accidentally dropped on the abdomen), heating pads, or a hot cup of tea. One patient had ecchymosis from blunt trauma during gardening. Out of 36 diabetic patients, more than 24 patients were insulin-dependent and used the area for subcutaneous insulin injections. In addition, some of the 43 hepatitis C virus-positive patients used the area for subcutaneous interferon therapy. In conclusion, 100% of the patients had persistent numbness up to 9 years following LTx. Five percent of the patients developed thermal injuries or blunt trauma complications that could have been prevented with better education and awareness. More then 24% of the patients used the area for subcutaneous injections of insulin and/or interferon.
authors.affiliation: Division of Abdominal Organ Transplant, Department of Surgery, Temple University Hospital, Philadelphia, PA 19140, USA. ashokkumar.jain@tuhs.temple.edu
authors.forename: Ashokkumar
authors.initials: A
authors.lastname: Jain
authors.forename: Pauline
authors.initials: P
authors.lastname: Nemitz
authors.forename: Rajeev
authors.initials: R
authors.lastname: Sharma
authors.forename: Baber
authors.initials: B
authors.lastname: Sheikh
authors.forename: Saman
authors.initials: S
authors.lastname: Safadjou
authors.forename: Marry
authors.initials: M
authors.lastname: Vetter
authors.forename: Leah
authors.initials: L
authors.lastname: Brayan
authors.forename: Pam
authors.initials: P
authors.lastname: Batzold
authors.forename: Randeep
authors.initials: R
authors.lastname: Kashyap
authors.forename: Mark
authors.initials: M
authors.lastname: Orloff
mesh_terms: D034861:Abdominal Wall / Q000294:innervation / Q000601:surgery*; D000328:Adult; D002056:Burns / Q000453:epidemiology; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000453:epidemiology*; D015994:Incidence; D017093:Liver Failure / Q000453:epidemiology* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D014949:Wounds, Nonpenetrating / Q000453:epidemiology