Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Abstract

Objective: The objective of this study was to determine the frequency of hepatic encephalopathy in post liver transplant patients at a tertiary care hospital in Punjab. Study Design: It was a descriptive case series. Setting: Research was conducted at Department of Gastroenterology, Shaikh Zayed Hospital Lahore. Duration: Duration of study was 6 months after the approval of synopsis from 05/08/2017 to 04/02/2018. Material and Methods: This study involved 139 patients of both genders aged between 30-70 years diagnosed of chronic liver disease and undergoing liver transplantation. Patients were followed in the post-transplant period and hepatic encephalopathy was diagnosed using West Haven Criteria ≥Stage I during 4 weeks period after transplant. A written informed consent was obtained from every patient. Results: The mean age of the patients was 48.1±8.6 years. Most of the patients were aged between 51-65 years (59.0%) followed by 35-50 years (41.0%). There were 90 (64.7%) male and 49 (35.3%) female patients in the study group with a male to female ratio of 1.8:1. Chronic hepatitis C was the most frequent underlying cause and was observed in 105 (75.5%) patients followed by chronic hepatitis B (12.9%) and autoimmune hepatitis (11.6%). Post-transplant hepatic encephalopathy was diagnosed in 17 (12.2%) patients. 10 (7.2%) patients had stage-I, 5 (3.6%) patients had stage-II and 2 (1.4%) patients had stage-III encephalopathy. There was no significant difference in the frequency of post-transplant hepatic encephalopathy across age (p-value=0.988), gender (p-value=0.997) and underlying cause (p-value=0.714). Conclusion: Hepatic encephalopathy was observed in a substantial proportion of patients undergoing liver transplantation for chronic liver disease which warrants routine monitoring of such patients in the post-operative period so that timely identification and management can improve the outcome among such cases. Keywords: Chronic Liver Disease, Liver Transplant, Hepatic Encephalopathy