Liver transplantation during infancy: No increased rate of neurological complications

Abstract

pLT is a highly standardized therapy for children with end‐stage liver disease and liver‐based metabolic diseases. However, NCs after transplantation occur and especially younger children are considered as more vulnerable and susceptible to NCs. Up to now, detailed data particularly for the very young age group do not exist. We therefore retrospectively studied NCs in children after pLT under age of 24 months. Forty children aged between 19 days and 22 months were evaluated according to type of NC and potential risk factors. NCs occurred in 8/40 patients (20%). All experienced new‐onset seizures and in 1/6 surviving patients, seizures evolved into epilepsy. Other NCs were intracerebral abscess (1/8 patients) and subdural hemorrhage (1/8 patients). The overall 3‐year mortality rate was 10% (4/40 patients). Significant risk factors for NCs and therefore seizures were HAT (P = 0.020), total surgery time (P = 0.009), retransplantation (P < 0.001), period of catecholamine therapy (P = 0.024), period of mechanical ventilation (P = 0.014), and period of sedation (P = 0.010). Our study is the first to provide detailed information on NCs after pLT in children under 24 months of age. The incidence of NCs in this particular group of very young patients was not increased compared to previously published data of children of all ages. Main NC was new‐onset seizure. In the surviving infants, prognosis of seizure was excellent and the risk of developing epilepsy was low. Even more, the occurrence of NCs did not significantly affect mortality or survival in this particular age group.

Changes in NSE and S‑100β during the perioperative period and effects on brain injury in infants with biliary atresia undergoing parent donor liver transplantation

“…Parental donor liver transplantation has become the most effective treatment for pediatric patients with ESLD ( 5 ), with a worldwide postoperative 5-year survival rate of 70-90% in 2011 ( 6 , 7 ). Although marked survival rate, complications after liver transplantation still occur ( 8 ). The incidence of neurological complications can be 20%, which severely affects postoperative survival rates compared to those without (50 vs. 7%) ( 9 ).…”