J Korean Neurol Assoc.  1997 Oct;15(5):1136-1147.

Neurologic complications following liver transplantation

• Lee JH
• Kang JK
• Lee SG

Abstract

Neurologic complication are associated with orthotopic liver transplantation. The purpose of this study was to show the neurological spectrum of possible contributing factors to the development of neurologic complication following liver transplantation. We retrospectively analyzed neurologic complications in 15 Korean adult patients who received liver transplantation since 1992. Thirteen of 15 patient developed neurologic complications in the postoperative period seizure(4 patients) ; tremor(4 patients) ; confusion( 5patients) ; central pontine myelinoIysis(CPM, 2 patients) ; multifactorial irreversible mental deterioration(5 patients). All of the patients with multifactorial irreversible mental deterioration expired. Their mental deterioration attributed to multiple metabolic derangement, especially hepatic failure or anoxic brain damage age and we thought that their pre-operative liver function were poorer than that of the other patients. In two of 4 patients with seizure, the fits were associated with irreversible mental deterioration. Except those 2 patients, in all of the patients with seizure, tremor or confusion, the symptoms resolved completely. In these cases, we could not determine the cause exactly. But we thought that cyclosporine or ganciclovir were possible contributing factors to the development of those complications in some case. In 2 patients with CPM, it was attributed to rapid correction of hyponatremia during intraoperative period. But in other patients without CPM, rapid rise of serum sodium level was also found. So it was possible that the frequency of CPM was underestimatd in this study.

MeSH Terms

Adult
Cyclosporine
Ganciclovir
Humans
Hyponatremia
Hypoxia, Brain
Intraoperative Period
Liver Failure
Liver Transplantation*
Liver*
Postoperative Period
Retrospective Studies
Seizures
Sodium
Tremor
Cyclosporine
Ganciclovir
Sodium