Late onset of tacrolimus-related posterior leukoencephalopathy after living donor liver transplantation

Frühauf, Nils R.; Koeppen, Susanne; Saner, Fuat H.; Egelhof, Thomas; Stavrou, Gregor A.; Nadalin, Silvio; Broelsch, Christoph E.

doi:10.1053/jlts.2003.50181

Cited by 21 publications

(10 citation statements)

References 7 publications

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“…However, our group published a case of a LDLT patient, who developed a TAC related PLE 3 months after transplantation. On admission she was comatose and remained unconscious until she died [12]. …”

Section: Discussionmentioning

confidence: 99%

Neurologic complications in adult living donor liver transplant patients: an underestimated factor?

et al. 2009

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Liver transplantation is the only curative treatment in patients with end-stage liver disease. Neurological complications (NC) are increasingly reported to occur in patients after cadaveric liver transplantation. This retrospective cohort study aims to evaluate the incidence and causes of NC in living donor liver transplant (LDLT) patients in our transplant center. Between August 1998 and December 2005, 121 adult LDLT patients were recruited into our study. 17% of patients experienced NC, and it occurred significantly more frequently in patients with alcoholic cirrhosis (42%) and autoimmune hepatitis (43%) as compared with patients with hepatitis B or C (9/10%, P = 0.013). The most common NC was encephalopathy (47.6%) followed by seizures (9.5%). The choice of immunosuppression by calcineurin inhibitor (Tacrolimus or Cyclosporin A) showed no significant difference in the incidence of NC (19 vs. 17%). The occurrence of NC did not influence the clinical outcome, since mortality rate, median ICU stay and length of hospital stay were similar between the two groups. Most patients who survived showed a nearly complete recovery of their NC. NCs occur in approximately 1 in 6 patients after LDLT and seem to be predominantly transient in nature, without major impact on clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Neurologic complications in adult living donor liver transplant patients: an underestimated factor?

et al. 2009

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“…The current term is misleading because the condition is not always restricted to posterior structures or white matter, nor reversible [10]. The accurate incidence of PLE is difficult to determine.…”

Section: Discussionmentioning

confidence: 99%

Neurological complications after cadaveric and living donor liver transplantation

Saner

Minouchehr

et al. 2006

J Neurol

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Problems related to the central nervous system have a major impact on survival and quality of life. The aim of this retrospective study was to evaluate the incidence of neurological complications after liver transplantation (LT), including both cadaveric and living donor liver transplantation. Between April 2001 and March 2004 174 patients (120 cadaveric liver transplantations, 54 living donor transplantations) were admitted to our intensive care after liver transplantation. Of the transplanted patients 24.7% developed neurological complications. These patients' stay in the intensive care (14.2 +/- 17.2 days) was much longer than that of all admitted patients (8.4 +/- 10.5 days, p < 0.05). The most common neurological complications were encephalopathy (72.1%) and seizures (11.6 %). The incidence of neurological complications in living donor liver transplanted patients was significantly lower than in cadaveric transplantation patients (20.4% vs 26.7 %). The cold ischemia time in living donor transplanted patients was significantly shorter in comparison with cadaveric transplanted patients (215 +/- 119.3 vs. 383.7 +/- 214.7). The survival rate after liver transplantation of patients with neurological complications was lower than that of patients without, but not significantly different (79.1 % vs. 82.4%, p > 0.05). The incidence of neurological symptoms was found to be similar between the patients treated with cyclosporine (25%) and tacrolimus (23.8 %) in this study. In conclusion, there was a high incidence of neurological complications after LT, prolonging the patients' stay in intensive care significantly. The major neurological manifestation in our patients was encephalopathy followed by seizures. Living donor liver transplantation was associated with a significantly lower incidence of neurological complications compared with patients who had received a cadaveric graft. This might be due to the good quality of the organ and the much shorter cold ischemia time of the graft when the donor was alive.

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“…Este síndrome consiste en un cuadro reversible de cefalea, alteraciones visuales, somnolencia y convulsiones, asociado a leucoencefalopatía, la que se localiza predominantemente en los lóbulos occipitales en las neuroimágenes 29 . Su patogenia se ha asociado a terapia inmunosupresora con ciclosporina y tacrolimus, encefalopatía hipertensiva y eclampsia [29][30][31][32][33] .…”

Section: Discussionunclassified

Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico: Experiencia de un centro universitario

et al. 2008

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Late onset of tacrolimus-related posterior leukoencephalopathy after living donor liver transplantation

Cited by 21 publications

References 7 publications

Neurologic complications in adult living donor liver transplant patients: an underestimated factor?

Neurologic complications in adult living donor liver transplant patients: an underestimated factor?

Neurological complications after cadaveric and living donor liver transplantation

Complicaciones neurológicas en pacientes adultos sometidos a trasplante hepático ortotópico: Experiencia de un centro universitario

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