Neuropsychiatric Complications Following Liver Transplantation

Objective: The aim of this retrospective study was to evaluate the prevalence of neuropsychiatric complications after living donor liver transplantation. Methods: Between May 2001 and April 2005, 110 recipients were admitted to ICU after LT and were evaluated by full general, psychiatric and neurological examination, EEG, brain CT and/or MRI, diagnosis of psychiatric disorders was according to DSM-IV-TR criteria, the presence or absence of PPS was evaluated on the basis of its diagnostic criteria, patients were observed after LT for one year. Results: Of transplanted patients 50.9% developed neuropsychiatric complications and these patients stay in the ICU was much longer that of all admitted patients. A neurologic complication was observed in 32.7%, psychiatric disorders in 43.6% of which 62.5% developed PPS. The survival rate after LT of patients with NPCs was similar to patients without NPCs. The incidence of neuropsychiatric symptoms was found to be similar between the patients treated with cyclosporine and tacrolimus. Finally, no correlation was observed between the primary cause of liver disease and the NPCs reported. Conclusion: There was a high incidence of neuropsychiatric complications after LT, prolonging the patients stay in intensive care significantly. Careful preoperative and post-operative neuropsychiatric evaluation is important for early diagnosis of NPCs.