HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pujol, A. Articles by Tolosa, E. Search for Related Content PubMed PubMed Citation Articles by Pujol, A. Articles by Tolosa, E.

Predictive factors of in-hospital CNS complications following liver transplantation

Service of Neurology (Drs. Pujol, Graus, Galofré, and Tolosa), the Liver Unit (Drs. Rimola, Navasa, and Rodés), and the Services of Anesthesiology (Dr. Beltrán) and Surgery (Drs. Garcia-Valdecasas, Grande, and Visa), Hospital Clinic i Provincial, University of Barcelona, Spain.

We prospectively evaluated 84 consecutive adult patients with chronic liver disease before and after liver transplantation to define the type and frequency of post-transplant neurologic complications, and to assess possible pretransplant and operative variables associated with in-hospital CNS complications. There were 25 patients (30%) who presented 23 neurologic complications of the central and six of the peripheral nervous system. Seventy-five percent of the complications occurred in the first month post-transplant. The most frequent CNS complications included anoxic (six patients) and septic (five) encephalopathy, as well as brain hemorrhage (five). Patients who presented CNS complications had a higher mortality rate than those who did not (55% versus 17%, p = 0.002). Multiple logistic regression analysis showed abnormal pretransplant neurologic examination suggestive of chronic hepatic encephalopathy (p = 0.007) and noncholestatic liver disease (p = 0.012) to be independently associated with in-hospital CNS complications. These data indicate that CNS neurologic complications following liver transplant are common in patients with noncholestatic liver disease and are associated with increased mortality. The pretransplant neurologic examination is an important predictor of CNS complications that occur in the immediate post-transplant period.

Address correspondence and reprint requests to Dr. Francesc Graus, Service of Neurology, Hospital Clínic i Provincial, Villarroel 170, 08036 Barcelona, Spain.

Received November 22, 1993. Accepted in final form January 18, 1994.

This article has been cited by other articles:

				I. Erol, F. Alehan, F. Ozcay, O. Canan, and M. Haberal Neurologic Complications of Liver Transplantation in Pediatric Patients With the Hepatic Form of Wilson's Disease J Child Neurol, March 1, 2008; 23(3): 293 - 300. [Abstract] [PDF]

				M. B. Lewis and P. D. Howdle Neurologic complications of liver transplantation in adults Neurology, November 11, 2003; 61(9): 1174 - 1178. [Abstract] [Full Text] [PDF]

				P. Sostak, C.S. Padovan, T.A. Yousry, G. Ledderose, H.-J. Kolb, and A. Straube Prospective evaluation of neurological complications after allogeneic bone marrow transplantation Neurology, March 11, 2003; 60(5): 842 - 848. [Abstract] [Full Text] [PDF]

				C. I. Buis, R. H. Wiesner, R. A.F. Krom, W. K. Kremers, and E. F.M. Wijdicks Acute confusional state following liver transplantation for alcoholic liver disease Neurology, August 27, 2002; 59(4): 601 - 605. [Abstract] [Full Text] [PDF]

				M. Wong, G. B. Mallory Jr., J. Goldstein, M. Goyal, and K. A. Yamada Neurologic complications of pediatric lung transplantation Neurology, October 1, 1999; 53(7): 1542 - 1542. [Abstract] [Full Text]