Abstract
BackgroundCerebrovascular complications are severe events following orthotopic liver transplantation (OLT). This study aimed to observe the clinical and neuroimaging features and possible risk factors of in-hospital cerebrovascular complications in the patients who underwent OLT.Patients and methodsWe retrospectively reviewed 337 consecutive patients who underwent 358 OLTs. Cerebrovascular complications were determined by clinical and neuroimaging manifestations, and the possible risk factors were analyzed in the patients with intracranial hemorrhage.ResultsTen of 337 (3.0%) patients developed in-hospital cerebrovascular complications (8 cases experienced intracranial hemorrhage and 2 cases had cerebral infarction), and 6 of them died. The clinical presentations were similar to common stroke, but with rapid deterioration at early stage. The hematomas on brain CT scan were massive, irregular, multifocal and diffuse, and most of them were located at brain lobes and might enlarge or rebleed. Infarcts presented lacunar and multifocal lesions in basal gangliar but with possible hemorrhagic transformation. The patients with intracranial hemorrhage had older age and a more frequency of systemic infection than non-intracranial hemorrhage patients. (P = 0.011 and 0.029, respectively).ConclusionPosttransplant cerebrovascular complications have severe impact on outcome of the patients who received OLT. Older age and systemic infection may be the possible risk factors of in-hospital intracranial hemorrhage following OLT.
Highlights
Cerebrovascular complications are severe events following orthotopic liver transplantation (OLT)
Brain computed tomography (CT) or magnetic resonance imaging (MRI) was performed in patients when neurological symptoms occurred after OLT
We focused on the clinical and neuroimaging features of the patients with in-hospital cerebrovascular complications following OLT, and analyzed the possible risk factors in the patients with intracranial hemorrhage
Summary
Cerebrovascular complications are severe events following orthotopic liver transplantation (OLT). This study aimed to observe the clinical and neuroimaging features and possible risk factors of in-hospital cerebrovascular complications in the patients who underwent OLT. Postoperative complications are still the most important causes resulting in death of patients undergoing OLT. States [1,2,3], 3.3% in United Kingdom[4], 3.7% in Chile[5], 6% in Spain[6], 6.5% in Hong Kong[7] clinically, and 32.7% in post-mortem patients after OLT in United States[8]. Cerebrovascular complications following OLT in patients of mainland China have not been reported. We reported the incidence, mortality and clinical and neuroimaging features, analyzed the possible risk factors of in-hospital cerebrovascular complications in patients following OLT at a center in southern China
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