Incidence, risk factors, and outcomes related with neurological events after liver transplantation in adult and pediatric recipients
| Autor: | Manuel Mendizabal, Jose Bueri, Ivone Malla, Joaquin Cagliani, Mariano Barreiro, Ariel Gonzalez Campaña, Yu Cheang, Luis G. Podesta, Marcelo Silva, Josefina Pages, Cristina Alonso, Martín Fauda, Carla Colaci, Federico Piñero |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty medicine.medical_treatment Encephalopathy 030230 surgery Liver transplantation 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors Ascites medicine Humans Cumulative incidence Longitudinal Studies Child Transplantation business.industry Incidence (epidemiology) Incidence Age Factors Infant Middle Aged medicine.disease Prognosis Liver Transplantation Child Preschool Pediatrics Perinatology and Child Health Cohort 030211 gastroenterology & hepatology Female medicine.symptom Nervous System Diseases business Cohort study |
| Zdroj: | Pediatric transplantation. 22(3) |
| ISSN: | 1399-3046 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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