Neurologic complications following liver transplantation

J Korean Neurol Assoc > Volume 15(5); 1997 > Article

Journal of the Korean Neurological Association 1997;15(5): 1136-1147.

간이식 후에 발생한 신경합병증

이주헌, 강중구, 이승규

울산대학교 의대 서울중앙병원 신경과. 일반외과

Neurologic complications following liver transplantation

Ju Hun Lee, M.D. , Joong Koo Kang, M.D. , Sung Gyu Lee,M.D.*

Dept of Neurology, Gerenal Surgery*, Ulsan Univ , College of Medicine, Asan Medical Center

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.