Early and late neurological complications of liver transplantation in pediatric patients

Pediatr Transplant. 2017 May;21(3). doi: 10.1111/petr.12872. Epub 2017 Jan 1.

Abstract

NCs occur commonly after solid organ transplantation and affect 15%-30% of liver transplant recipients. The aim of this retrospective study was to evaluate the type and incidence of neurologic events in pediatric patients following LT. Between May 2006 and June 2015, 242 patients (118 females, 124 males) requiring LT for different etiologies at the İnönü University Liver Transplantation Institute were included. The incidence, types, and risk factors of NCs that occurred following LT were evaluated retrospectively. Neurologic events occurred in 57 (23.5%) of the patients. Early NCs were encephalopathy (12.4%), seizures (11.5%), and PRES (7%). Of 57 patients, five (8.7%) experienced NCs at least 1 month after LT; these late NCs included tremor, headaches, encephalopathy, ataxia, and neuropathy. The psychiatric symptoms after LT were noted in 42 patients (17.4%). The mortality rate after LT in those with or without neurological events was not significantly different (P=.73). There was a high incidence of serious neurologic events after LT. The major neurologic manifestation in our patients was encephalopathy followed by seizures.

Keywords: childhood; liver transplantation; neurological complication.

MeSH terms

  • Adolescent
  • Brain Diseases / etiology
  • Child
  • Child, Preschool
  • End Stage Liver Disease / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Infant
  • Liver Transplantation / adverse effects*
  • Male
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology*
  • Retrospective Studies
  • Risk Factors
  • Seizures / etiology

Substances

  • Immunosuppressive Agents