Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation.
BACKGROUND
Hepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications.


METHODS
Here we describe a case of hepatic artery thrombosis after living-donor liver transplantation which was not preceded by signs of liver failure but rather by an episode of acute psychosis. After re-transplantation the patient recovered without sequelae.


CONCLUSIONS
This case highlights the need to remain cautious when psychiatric disorders occur in patients after liver transplantation. The diagnostic procedures should not be restricted to medical or neurological causes of psychosis alone but should also focus vascular complications related to orthotopic liver transplantation.
Goralczyk
Armin D
AD
Department of General and Visceral Surgery, University Medical Center Göttingen, Göttingen, Germany. agoralczyk@med.uni-goettingen.de
Meier
Volker
V
Ramadori
Giuliano
G
Obed
Aiman
A
Lorf
Thomas
T
D000208:Acute Disease; D000328:Adult; D006499:Hepatic Artery; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D010259:Paranoid Disorders / Q000209:etiology*; D013927:Thrombosis / Q000150:complications*; D016896:Treatment Outcome