Neurological complications after liver transplantation as a consequence of immunosuppression: univariate and multivariate analysis of risk factors

Transplant International : Official Journal of the European Society for Organ Transplantation
Gianluca RompianesiGiorgio E Gerunda

Abstract

Neurological complications (NCs) can frequently and significantly affect morbidity and mortality of liver transplant (LT) recipients. We analysed incidence, risk factors, outcome and impact of the immunosuppressive therapy on NC development after LT. We analysed 478 LT in 440 patients, and 93 (19.5%) were followed by NCs. The average LOS was longer in patients experiencing NCs. The 1-, 3- and 5-year graft survival and patient survival were similar in patients with or without a NC. Multivariate analysis showed the following as independent risk factors for NC: a MELD score ≥20 (OR = 1.934, CI = 1.186-3.153) and an immunosuppressive regimen based on calcineurin inhibitors (CNIs) (OR = 1.669, CI = 1.009-2.760). Among patients receiving an everolimus-based immunosuppression, the 7.1% developed NCs, vs. the 16.9% in those receiving a CNI (P = 0.039). There was a 1-, 3- and 5-year NC-free survival of 81.7%, 81.1% and 77.7% in patients receiving a CNI-based regimen and 95.1%, 93.6% and 92.7% in those not receiving a CNI-based regimen (P < 0.001). In patients undergoing a LT and presenting with nonmodifiable risk factors for developing NCs, an immunosuppressive regimen based on CNIs is likely to result in a higher rate of NCs compared t...Continue Reading

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Citations

Dec 29, 2015·Human Immunology·Julieta LazarteDiego H Delgado
Jun 12, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Julieta LazarteDiego Delgado
Nov 30, 2016·Transplant International : Official Journal of the European Society for Organ Transplantation·Georg Heinze, Daniela Dunkler
Dec 29, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Umberto CilloErida Nure
Apr 23, 2019·Alimentary Pharmacology & Therapeutics·Birte SchmitzXiao-Qi Ding
May 16, 2019·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Mohammad Hasan MohammadiFateme Parooie
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Nov 21, 2017·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Henning PflugradKarin Weissenborn
Aug 23, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Anna-Elisabeth HoppHenning Pflugrad
Feb 7, 2021·Brain & Development·Keita KanamoriMureo Kasahara
May 13, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Meike DirksKarin Weissenborn
Jun 5, 2021·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Wen-Yuan ChenYao-Li Chen
May 22, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Chathur Acharya, Jasmohan S Bajaj

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