Neuropsychiatric complications after liver transplantation : Role of immunosuppression and hepatitis C

• Published in: Digestive diseases and sciences 2006-06, Vol.51 (6), p.1079-1081
• Main Authors: TOMBAZZI, Claudio R, WATERS, Bradford, SHOKOUH-AMIRI, M. Hosein, VERA, Santiago R, RIELY, Caroline A
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Cyclosporine - administration & dosage; Cyclosporine - adverse effects; Depressive Disorder - epidemiology; Depressive Disorder - etiology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Hepatitis C, Chronic - surgery; Human viral diseases; Humans; Immunocompromised Host; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - adverse effects; Incidence; Infectious diseases; Liver Diseases - surgery; Liver Transplantation - psychology; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical Records; Medical sciences; Middle Aged; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Tacrolimus - administration & dosage; Tacrolimus - adverse effects; Tennessee - epidemiology; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Viral diseases; Viral hepatitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-006-8012-0

Neuropsychiatric complications are an important source of morbidity following orthotopic liver transplantation. Etiology of liver disease and type of immunosuppression are possible related factors. The aim of this study was to describe the prevalence of neuropsychiatric complications after liver transplantation, the role of immunosuppression, and the association between these and specific liver diseases such as hepatitis C. One hundred twenty-eight patients with liver transplants were studied. Tacrolimus was the primary immunosuppressant in 101 patients and cyclosporine in 27 patients. Seventy-five complications in 49 patients (38.2%) were reported. In 43 patients, the etiology was associated with immunosuppression: 36 on tacrolimus and 7 on cyclosporine (P = 0.34). Seventeen and four-tenths percent of patients with hepatitis C and 4.6% of patients without hepatitis C developed depression (P = 0.02). There is no difference between types of primary immunosuppression and neuropsychiatric complications. There is a significantly greater incidence of depression in patients transplanted for hepatitis C.