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Neurological Complications Following Pediatric Liver Transplant: A Single Center Experience.
MedLine Citation:
PMID:  22167017     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: We studied neurological complications (NC) after liver transplantation (LT) in children. METHODS:: We performed an IRB-approved retrospective review of LT patients ≤ 21 years over a period of 30 years (1980-2010). NC were classified as early (within 3 months post-LT) and delayed (beyond 3 months post-LT). RESULTS:: Of 65 children with LT, 20 (30.7%) had NC, 16 were females. Mean age was 11.8 ± 5.9 years. Early NC: 13.8% (9/65 patients) - seizures in 7 and encephalopathy in 2. Abnormal neuroimaging findings were: posterior reversible leucoencephalopathy syndrome (1), intracranial hemorrhage (ICH) (1), mild cerebral edema (1) and bilateral basal ganglia T1W hyperintensities in MRI (1). On follow-up there were 3 deaths (unrelated to NC). One with ICH had residual hemiparesis who received long-term antiepileptic drug (AED). Late NC: 16.9% (11/65 patients) - seizures in 4, headache in 4, encephalopathy in 3 (1 had seizures in addition) and paresthesias due to possible small fiber neuropathy in 1. Abnormal neuroimaging findings were: hypoxic-ischemic encephalopathy (1), encephalomalacia due to old hemorrhage (1) and hyperintensity of the posterior periventricular white matter in MRI (1). On follow-up all patients survived. One had papilledema with secondary optic atrophy requiring optic nerve sheath fenestration and one needed long-term AED. CONCLUSIONS:: NC are common in children after LT, seizures being the commonest. In contrary to the previous studies we found delayed complications more than early complications. Early detection and appropriate management of NC is important.
Authors:
Partha S Ghosh; Vera Hupertz; Debabrata Ghosh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-12
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  -     ISSN:  1536-4801     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Pediatric Neurology Center, Cleveland Clinic, Cleveland, USA †Department of Pediatric Gastroenterology & Hepatology, Cleveland Clinic, Cleveland, USA. 1Co-authors: Partha S. Ghosh, MD, E-mail: ghoshp3@ccf.org. 2Vera Hupertz, MD, E-mail: hupertv@ccf.org.
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