CEREBROVASCULAR COMPLICATIONS AFTER LIVING DONOR LIVER TRANSPLANTATION

Aim: Central nervous system complications are an important cause of morbidity and mortality in transplant recipients. However, cerebrovascular complications (CVC) after living donor liver transplantation (LDLT) have seldom been reported. Methods: Between June 1990 and December 2007, 1297 patients underwent LDLT at Kyoto University Hospital. A retrospective review of all patients who developed CVC after LDLT was performed. Results: Of1297 patients who received living donor liver transplantation (LDLT) at Kyoto University Hospital between June 1990 and December 2007, 14 (1.1%) developed CVC, including 11 with intracerebral hemorrhage and 3 with cerebral infarction. The onset of intracerebral hemorrhage was within 60 days (range, 1 to 58 days; median, 7 days) after LDLT. Twelve offourteen patients died from CVC, for a mortality rate of 85.7%. Two patients had aspergillosis. Four cases had undergone retransplantation, and three patients had fulminant hepatic failure. Craniotomy with hematoma evacuation was performed in one patient. Conclusion: Though CVC is not a very common post-transplant complication, it carries a poor prognosis, as it occurs mostly in critically ill and complicated cases. Therefore, every effort should be made to prevent CVC