| ORIGINAL ARTICLE |
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| Year : 2016 | Volume
: 53
| Issue : 4 | Page : 225-231 |
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Neuropsychiatric complications after liver transplantation
Mohamed E Elwan1, Rasha A El-Kabany1, Amr S Shalaby1, Ibrahim E Alahmar1, Osama Hegazy2, Mona S Elkholy MD 1
1 Department of Neuropsychiatry, Faculty of Medicine, Menoufya University, Al Minufya, Egypt
2 National Liver Institute, Menoufya University, Al Minufya, Egypt
Correspondence Address:
Mona S Elkholy
Department of Neuropsychiatry, Faculty of Medicine, Menoufya University, Al Minufya
Egypt
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1110-1083.202382
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Background
Neuropsychiatric complications are responsible for significant mortality and morbidity after liver transplantation (LT).
Objective
The aim of this study was to detect the neuropsychiatric complications after LT, and to identify any possible relationship between these complications and certain perioperative risk factors.
Materials and Methods
The study was performed on 35 patients admitted in the National Liver Institute, Menoufiya University, who underwent LT. Patients were assessed 2 weeks preoperatively and followed up for 3 months postoperatively. Preoperatively, clinical assessment, mini mental state examination, Bender–Gestalt test, trail making test, structured clinical interview for DSM-IV axis I disorders scale, assessment using the hospital anxiety depression scale, laboratory tests for hepatic disease and comorbidities, cerebral computerized tomography and/or MRI, carotid duplex and electroencephalography were carried out. Intraoperatively, assessment of warm and cold ischemia time, operative time, and blood transfusion was carried out. Postoperatively, clinical examination, mini mental state examination, Bender–Gestalt test, trail making test, assessment with the structured clinical interview for DSM-IV axis I disorders scale and the hospital anxiety depression scale, brain imaging, electroencephalography, nerve conduction studies, and electromyogram were carried out.
Results
Postoperatively, neurological complications were detected in 13 (37.1%) patients in the form of central complications, such as encephalopathy, seizures, and cerebrovascular strokes, and peripheral neuropathies. However, psychiatric complications were detected in 15 (42.9%) patients in the form of cognitive disorders, maladjustment, anxiety disorders, major depressive disorders, and brief psychotic episode.
Conclusion
This work showed that, in adult patients undergoing living donor LT, there was a relevant variety of neurological and psychiatric complications, which represented significant causes of postoperative morbidity and should be diagnosed and managed early. |
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