INeurological complications in recipients after living donor liver transplantation
Mohamed Ibrahim Mohamed Hassan Khalil;
Abstract
Background and Objective:Neurological complications (NC) affects up
to one third of patients after Liver transplantation (LT). The aim of this
study is to assess the incidence, risk factors and clinical presentation of
NC after liver transplantation in patients who underwent living donor
liver transplantation (LDLT) in Egypt.
Methods: Between November 2011 and December 2013, 149 patients
from diffrent centers were observed for one month after LDLT and
evaluated by full general and neurological examination, assessment of
encephalopathy by West Haven classification, full laboratory
investigations including drug levels, and brain CT and/or MRI.
Results: 46 patients (30.9%) developed neurological complications 30 of
which (20.1%) developed side effects related to Tacrolimus (FK-506)
and 2 patients (1.3%) developed side effects related to cyclosporine. The
most common neurological complications were Encephalopathy (14.1%)
while the least were both Central pontine myelinolysis and
Meningoencephalitis (0.7%). Patients were classified into complicated
and noncomplicated groups. The mean Serum level of Tacrolimus (FK-
506) was higher in complicated than noncomplicated patients yet both
were within the normal therapeutic range with no statistically significant
difference. A highly significant association was found regarding the
relation between FK-506 and neurological complications in both groups.
Neither the age nor the preoperative risk factors (diabetes mellitus,
hypertension) had significant correlation with the early postoperative
neurological complications. In all patients, there was no statistical
significant correlation between FK506 and the other studied parameters
while there was a positive correlation between FK506 and total bilirubin
(r= 0.226; p= 0.006). FK506 was positively correlated with both direct
bilirubin (r= 0.160; p= 0.053) and ammonia (r= 0.146; p= 0.078) no
statistical significant correlation were found between cyclosporine and
different studied parameters. In neurologically complicated patients,
FK506 was positively correlated with both total bilirubin (r= 0.272; p=
0.089) and direct bilirubin
to one third of patients after Liver transplantation (LT). The aim of this
study is to assess the incidence, risk factors and clinical presentation of
NC after liver transplantation in patients who underwent living donor
liver transplantation (LDLT) in Egypt.
Methods: Between November 2011 and December 2013, 149 patients
from diffrent centers were observed for one month after LDLT and
evaluated by full general and neurological examination, assessment of
encephalopathy by West Haven classification, full laboratory
investigations including drug levels, and brain CT and/or MRI.
Results: 46 patients (30.9%) developed neurological complications 30 of
which (20.1%) developed side effects related to Tacrolimus (FK-506)
and 2 patients (1.3%) developed side effects related to cyclosporine. The
most common neurological complications were Encephalopathy (14.1%)
while the least were both Central pontine myelinolysis and
Meningoencephalitis (0.7%). Patients were classified into complicated
and noncomplicated groups. The mean Serum level of Tacrolimus (FK-
506) was higher in complicated than noncomplicated patients yet both
were within the normal therapeutic range with no statistically significant
difference. A highly significant association was found regarding the
relation between FK-506 and neurological complications in both groups.
Neither the age nor the preoperative risk factors (diabetes mellitus,
hypertension) had significant correlation with the early postoperative
neurological complications. In all patients, there was no statistical
significant correlation between FK506 and the other studied parameters
while there was a positive correlation between FK506 and total bilirubin
(r= 0.226; p= 0.006). FK506 was positively correlated with both direct
bilirubin (r= 0.160; p= 0.053) and ammonia (r= 0.146; p= 0.078) no
statistical significant correlation were found between cyclosporine and
different studied parameters. In neurologically complicated patients,
FK506 was positively correlated with both total bilirubin (r= 0.272; p=
0.089) and direct bilirubin
Other data
| Title | INeurological complications in recipients after living donor liver transplantation | Authors | Mohamed Ibrahim Mohamed Hassan Khalil | Issue Date | 2015 |
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