Revista médica de Chile
versión impresa ISSN 0034-9887
MELLADO, Patricio et al. Neurological complications following a liver transplantation: Experience from a Chilean center. Rev. méd. Chile [online]. 2008, vol.136, n.10, pp. 1255-1263. ISSN 0034-9887. doi: 10.4067/S0034-98872008001000004.
Background: Orthotopic liver transplantation (OLT) is the treatment of choice for multiple acute and chronic end-stage liver diseases as well as for selected cases of liver malignancy and ¡iver-site metabolic disorders. Neurological impairment is a major source of morbidity and moñality following OLT. Aim: To describe the incidence and the type of neurological complications occurring in the post-operative period of OLT in patients transplanted in our hospital. Material and methods: Between March 1994 and August 2007, 76 adult patients underwent OLT. Data on incidence, time of onset, and outcome of central nervous system (CNS) complications have been obtained from our program data base and patient charts. Results: Twenty three patients (30.3%) had CNS complications following OLT. The leading complications were immunosuppressive drug-related neurological impairment in nine patients (39.1%), peripheral nerve damage in five patients (21.7%), central pontine myelinolysis in four patients (17.4%), cerebrovascular disease in three (13%) and CNS infection in three (13%). Most CNS events (90%) occurred in the first 2 weeks after OLT. Five patients with neurological complications died (22%). Conclusions: CNS complications occurred in almost one fifth of the population studied, and they had a poor outcome, as previously reported).
Palabras clave : Cerebrovascular disease; Liver transplantation; Myelinolysis; central pontine.