Neuropsychiatric complications after liver transplantation: Retrospective analysis of three cases and literature review
- VernacularTitle:肝移植术后神经精神系统并发症:3例回顾性分析及文献复习
- Author:
Chunyou LI
;
Sen LI
;
Yunqiang FU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;11(38):7689-7692
- CountryChina
- Language:Chinese
-
Abstract:
It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery, Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder, and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy, a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one, male aged 54 years of hepatitis B liver cirrhosis and large, with a history of hypertension for 15 years and diabetes for 10 years. On September 25th, 2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia, hyperkalemia, liver and kidney failure clinically. Case two, male aged 47 years of hepatitis B, cirrhosis and huge hepatocellular carcinoma, chronic calculous cholecystitis, with a history of hypertension for 5 years and diabetes for 2 years. On December 26th, 2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm, sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53, drowsiness and depressed spirit appeared; at day 54, the patient was disoriented, and at day 55 hemiparesis occurred at right side, gradually coma, by brain CT scan it confirmed to be intracerebral hemorrhage, and died. Case three, male aged 59 years of hepatitis B, cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th, 2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia, gradually motor dysfunction, swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium, chloral hydrate enema and luminal sodium treatment, focal epilepsy and irritable symptoms were effectively controlled, but aphasia and left hemiparesis still occurred. After five months, the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides, brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding, maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.
