title: Neuromuscular complication after liver transplant in children: a single-center experience.
abstract: OBJECTIVE
  Neurologic complications are a significant cause of morbidity in children after liver transplant. In this study, we sought to evaluate the neurologic complications in children after liver transplant.
  
  
  METHODS
  All children aged younger than 18 years old who had undergone liver transplant between June 2004 and June 2007 were included in this prospective study. There were 30 boys (62.5%) and 18 girls (37.5%) (mean age, 9.6 -/+ 4.3 years; mean duration of follow-up, 21.6 -/+ 9.4 months). The most common indications for liver transplant were biliary atresia (n=12, 25%), Wilson disease (n=7, 14.6%), tyrosinemia (n=7, 14.6%), progressive familial intrahepatic cholestasis (n=6, 12.5%), and autoimmune cirrhosis (n=5, 10.4%).
  
  
  RESULTS
  Immunosuppressive medication consisted tacrolimus (n=44, 91.7%) or cyclosporine (n=4, 8.3%) combined with mycophenolate mofetil (n=33, 68.7%) and prednisolone (n=18, 37.5%). The most-common neurologic complications were tremor (n=8, 16.7%), convulsions (n=6, 12.5%), insomnia (n=6, 12.5%), headache (n=5, 10.4%), muscle cramps (n=5, 10.4%), paresthesia (n=3, 6.2%), and weakness (n=3, 6.2%).
  
  
  CONCLUSIONS
  We conclude that the most-common neurologic complication after liver transplant in children in contrast to other studies is tremor, same as adult patients. This may be due to higher rate of use of tacrolimus in our patients.
authors.affiliation: Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Dehghani
authors.forename: Naser
authors.initials: N
authors.lastname: Honar
authors.forename: Soroor
authors.initials: S
authors.lastname: Inaloo
authors.forename: Siavash
authors.initials: S
authors.lastname: Gholami
authors.forename: Kourosh
authors.initials: K
authors.lastname: Kazemi
authors.forename: Ali
authors.initials: A
authors.lastname: Bahador
authors.forename: Mahmood
authors.initials: M
authors.lastname: Haghighat
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Malek-Hosseini
mesh_terms: D000293:Adolescent; D001327:Autoimmune Diseases / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002780:Cholestasis, Intrahepatic / Q000601:surgery*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation / Q000276:immunology*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011446:Prospective Studies; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology*; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014202:Tremor / Q000453:epidemiology*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid; D016559:Tacrolimus