Acute paranoid psychosis as sole clinical presentation of hepatic artery thrombosis after living donor liver transplantation

Abstract

BackgroundHepatic artery thrombosis is a devastating complication after orthotopic liver transplantation often requiring revascularization or re-transplantation. It is associated with considerably increased morbidity and mortality. Acute cognitive dysfunction such as delirium or acute psychosis may occur after major surgery and may be associated with the advent of surgical complications.Case presentationHere we describe a case of hepatic artery thrombosis after living-donor liver transplantation which was not preceded by signs of liver failure but rather by an episode of acute psychosis. After re-transplantation the patient recovered without sequelae.ConclusionThis case highlights the need to remain cautious when psychiatric disorders occur in patients after liver transplantation. The diagnostic procedures should not be restricted to medical or neurological causes of psychosis alone but should also focus vascular complications related to orthotopic liver transplantation.

Liver Transplant—Psychiatric and Psychosocial Aspects

“…Hepatic artery thrombosis has been found to be associated with development of psychosis. 86 Hence a careful assessment of the symptoms, and proper psychiatric examination is warranted.…”