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Incidence, risk factors, and outcomes related with neurological events after liver transplantation in adult and pediatric recipients
Author(s) -
Piñero Federico,
Cheang Yu,
Mendizabal Manuel,
Cagliani Joaquín,
Gonzalez Campaña Ariel,
Pages Josefina,
Colaci Carla,
Barreiro Mariano,
Alonso Cristina,
Malla Ivone,
Fauda Martín,
Bueri Jose,
Podesta Luis G,
Silva Marcelo
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13159
Subject(s) - medicine , incidence (geometry) , liver transplantation , pediatrics , transplantation , young adult , intensive care medicine , physics , optics
Controversy exists whether NE after LT are more frequently observed in children or adults. We aimed to compare the incidence and outcomes for NE after LT in pediatric and adult recipients. A single‐center cohort study, including all LT between 2001 and 2013, was performed. Definition of NE included impaired consciousness, delirium, seizures, focal neurologic deficit, visual impairment, or slurred speech. A cohort of 443 consecutive LT recipients was included: 307 adults and 136 children. Cumulative incidence of NE was similar between adults 15% (n = 41) and children 16% (n = 20; P = .73) with a complete neurological recovery in 62% and 95% of the patients, respectively ( P < .0001). Adults with NE had significantly lower survival (70% vs 76%; P = .015) with a HR of 2.36; this was similarly observed in children (45% vs 66%; HR 2.05, CI 0.66; 6.34). Independent risk factors for NE in adults were pre‐LT ascites, delta sodium, and post‐LT hypomagnesemia, whereas in children pre‐LT encephalopathy ≥II and serum albumin were associated with NE. Although a similar incidence of NE after LT was observed, children were more likely to achieve neurological recovery. Risk factors for the development of NE are difficult to assess in both populations.