title: Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation.
abstract: 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.
authors.affiliation: Department of General and Visceral Surgery, University Medical Center Göttingen, Göttingen, Germany. agoralczyk@med.uni-goettingen.de
authors.forename: Armin D
authors.initials: AD
authors.lastname: Goralczyk
authors.forename: Volker
authors.initials: V
authors.lastname: Meier
authors.forename: Giuliano
authors.initials: G
authors.lastname: Ramadori
authors.forename: Aiman
authors.initials: A
authors.lastname: Obed
authors.forename: Thomas
authors.initials: T
authors.lastname: Lorf
mesh_terms: 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