Evaluation of Early Postoperative Neurological Complications Following Living Donor Liver Transplantation

Otan, Emrah; Aydın, Cemalettin; Yönder, Hüseyin; Kayaalp, Cüneyt; Kaplan, Yüksel; Yilmaz, Sezai

doi:10.5152/npa.2015.7226

Cited by 6 publications

(6 citation statements)

References 9 publications

(19 reference statements)

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“…We found a male to female ratio of 1.8:1 in our study group, which included 90 men (64.7%) and 49 women (35.3%). Otan et al (2015) found a male-to-female ratio of 1.8:1 among liver transplant recipients in Turkey, which is in line with other studies [18]. Among liver transplant patients, males outnumber females (1.6:1), Dhar et al…”

Section: Resultssupporting

confidence: 83%

Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Nadeem¹,

Farooq²,

Muhammad³

et al. 2022

PJMHS

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Objective: The objective of this study was to determine the frequency of hepatic encephalopathy in post liver transplant patients at a tertiary care hospital in Punjab. Study Design: It was a descriptive case series. Setting: Research was conducted at Department of Gastroenterology, Shaikh Zayed Hospital Lahore. Duration: Duration of study was 6 months after the approval of synopsis from 05/08/2017 to 04/02/2018. Material and Methods: This study involved 139 patients of both genders aged between 30-70 years diagnosed of chronic liver disease and undergoing liver transplantation. Patients were followed in the post-transplant period and hepatic encephalopathy was diagnosed using West Haven Criteria ≥Stage I during 4 weeks period after transplant. A written informed consent was obtained from every patient. Results: The mean age of the patients was 48.1±8.6 years. Most of the patients were aged between 51-65 years (59.0%) followed by 35-50 years (41.0%). There were 90 (64.7%) male and 49 (35.3%) female patients in the study group with a male to female ratio of 1.8:1. Chronic hepatitis C was the most frequent underlying cause and was observed in 105 (75.5%) patients followed by chronic hepatitis B (12.9%) and autoimmune hepatitis (11.6%). Post-transplant hepatic encephalopathy was diagnosed in 17 (12.2%) patients. 10 (7.2%) patients had stage-I, 5 (3.6%) patients had stage-II and 2 (1.4%) patients had stage-III encephalopathy. There was no significant difference in the frequency of post-transplant hepatic encephalopathy across age (p-value=0.988), gender (p-value=0.997) and underlying cause (p-value=0.714). Conclusion: Hepatic encephalopathy was observed in a substantial proportion of patients undergoing liver transplantation for chronic liver disease which warrants routine monitoring of such patients in the post-operative period so that timely identification and management can improve the outcome among such cases. Keywords: Chronic Liver Disease, Liver Transplant, Hepatic Encephalopathy

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Section: Resultssupporting

confidence: 83%

Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Nadeem¹,

Farooq²,

Muhammad³

et al. 2022

PJMHS

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“…The brain is one of them, and HIRI-related neurological complication includes encephalopathy, epileptic seizures, posterior leukoencephalopathy syndrome, infection, and central pontine myelinolysis [23]. These complications are closely associated with significant mortality and morbidity and lead to a longer duration of postoperative hospitalization [24]. In addition, the incidence of neurological complication after pediatric liver transplantation, which resulted from biliary atresia and other protopathy, is as high as 46% due to the vulnerability of a developmental brain [25].…”

Section: Discussionmentioning

confidence: 99%

Exosomes Mediate Hippocampal and Cortical Neuronal Injury Induced by Hepatic Ischemia-Reperfusion Injury through Activating Pyroptosis in Rats

Zhang

Liu

Jia

et al. 2019

Oxidative Medicine and Cellular Longevity

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Background The neuronal injury and cognitive dysfunction after liver transplantation have severe effects on the prognosis and life quality of patients. Accumulating evidence suggests that both exosomes and pyroptosis could participate in hepatic ischemia-reperfusion injury (HIRI) and play key roles in neuronal death. However, the link between exosomes and neuronal pyroptosis in HIRI awaits further investigation. Methods After establishing the HIRI rat models, we primarily studied the role of pyroptosis in hippocampal and cortical neuron injury through detecting NOD-like receptor protein 3 (NLRP3), pro-caspase-1, cleaved-caspase-1, apoptosis-associated speck-like protein containing CARD (ASC), gasdermin D (GSDMD), interleukin-1beta (IL-1β), and interleukin-18 (IL-18) expressions with western blotting, immunohistochemical staining, and enzyme-linked immunosorbent assay (ELISA). Then, we intravenously injected normal male rats with exosomes isolated from the sera of HIRI-challenged rats and pretreated rats with MCC950, a specific inhibitor of NLRP3, and carried out the same assay. We also detected the levels of reactive oxygen species (ROS), superoxide dismutase (SOD), and malondialdehyde (MDA) in the hippocampal and cortical tissues. Results The results indicated that NLRP3 inflammasome and caspase-1-dependent pyroptosis were activated in the hippocampus and cortex of HIRI rats. Furthermore, serum-derived exosomes from HIRI-challenged rats not only had the ability to cross the blood-brain barrier (BBB) but also had the similar effects on neuronal pyroptosis. Moreover, ROS and MDA productions were induced in the HIRI and exosome-challenged groups. In addition, to some degree, MCC950 could alleviate HIRI-mediated hippocampal and cortical neuronal pyroptosis. Conclusion This study experimentally demonstrated that circulating exosomes play a critical role in HIRI-mediated hippocampal and cortical injury through regulating neuronal pyroptosis.

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“…In this study, the blood concentration of tacrolimus had little effect on NCs (p > 0.1). Although many reports have previously stated that tacrolimus is an independent risk factor for NCs (Otan et al, 2015a), most transplant centers currently have more positive experience in the administration of tacrolimus, which may help reduce the incidence of NCs. We also compared the dosasge of tacrolimus and found no statistical difference between the two groups (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…It is reported that up to 30% of the patients in western countries developed neurological complications after LT, but only 4% after heart transplantation and 0.5% after renal transplantation (Agildere et al, 2006, Amodio et al, 2007, Bronster et al, 2000. Frequent complications include acute confusion, epilepsy, cerebrovascular disease (Otan et al, 2015a(Otan et al, , 2015b, and central system infection (Weiss and Thabut, 2019). These symptoms lead to a decline in the quality of life of patients, and even increase the mortality rate (Ghaus et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Association between donor/recipient MTRR gene polymorphisms and the risk of new-onset neurological complications after liver transplantation

Wang

Liu

Wang

et al. 2021

Journal of Neuroimmunology

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Neurological complications are very common after liver transplantation. This study focuses on clinical risk factors and susceptibility gene polymorphisms of neurological complications after liver transplantation. A better predictive model is obtained. This study proves that MTRR is an independent susceptibility gene for neurological complications. Compared with the independent risk factor of abdominal infection, MTRR has a more advantageous value in predicting neurological complications after liver transplantation.

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Evaluation of Early Postoperative Neurological Complications Following Living Donor Liver Transplantation

Abstract: Mortality was significantly higher and the duration of postoperative hospitalization significantly longer in LDLT patients with new-onset neurological complications than in those without such complications.

Cited by 6 publications

References 9 publications

Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Exosomes Mediate Hippocampal and Cortical Neuronal Injury Induced by Hepatic Ischemia-Reperfusion Injury through Activating Pyroptosis in Rats

Association between donor/recipient MTRR gene polymorphisms and the risk of new-onset neurological complications after liver transplantation

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