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Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the Centro de Investigaciones Médico Quirúrgicas in Cuba

A. Abdo-Cuza, L. González-Rapado, O. López-Cruz, J. Pérez-Bernal, R. Castellanos-Gutiérrez, F. Gómez-Peyre, R. Hinojosa-Pérez, J. Lage-Dávila, A. Álvarez-Rodríguez, A. Fernández-Valle, I. Fernández-Maderos, M. Samada-Suárez, J.C. Hernández-Perera, A. Bernardos-Rodríguez [REV NEUROL 2003;37:18-21] PMID: 12861502 DOI: https://doi.org/10.33588/rn.3701.2002351

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Volumen 37 | Number 01 | Nº of views of the article 5.624 | Nº of PDF downloads 276 | Article publication date 01/07/2003

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ABSTRACT

INTRODUCTION Liver transplant (LT) is today a first choice procedure in a group of hepatic diseases in their acute and chronic terminal stages. It is not, however, a technique that is completely free of complications and those of a neurological nature constitute between 8-47% of those reported. AIMS. The purpose of this study is to present the immediate neurological complications (NC) found in our patients, as well as to determine the predictive factors and their relation to the mortality rate.

PATIENTS AND METHODS From the medical records of 26 patients who received LT at the CIMEQ (July 1999-December 2001), we collected a group of variables related to the donor, the surgical procedure and the post-operative period and associated them to the occurrence of NC while these patients were in the ICU.

RESULTS NC were found in 16 patients (61.5%), the most frequent being encephalopathy (30.8%), tremor (26.9%), and convulsions (19.2%). No relation was found between the presence of NC and prior hepatic encephalopathy, the use of a suboptimal donor, nor did it represent a significant increase in the mortality rate. There was a significant relation with LT to recipients rated as grade C on the Child-Pugh classification system, the presence of intraoperative hypotension (p= 0.0164) and primary dysfunction of the liver graft (p= 0.041).

CONCLUSIONS NC represented a significant cause of morbidity in the period following a liver transplant in our series, although they had no significant repercussion on the mortality rate. Their presence is related to variables concerning the recipient, the surgical procedure itself and the immediate post-operative period. KeywordsConvulsions Encephalopathy Liver transplant Neurological complications Predictive factors Tremor CategoriesTrastornos del movimiento

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Original

Predictive factors of neurological complications in the period immediately after liver transplant: experiences in the Centro de Investigaciones Médico Quirúrgicas in Cuba