Early neurological complications in liver transplant recipients at Pablo Tobón Uribe Hospital, Medellín, Colombia (2017–2023)

Abstract

Background. Liver diseases are a major cause of morbidity and mortality, with liver transplantation being the only definitive treatment. However, neurological complications occur in 15% to 30% of cases, impacting patient outcomes. This study explores differences in the biochemical and clinical profile of patients aged ≥ 18 years, who underwent liver transplantation (LT) at the Pablo Tobón Uribe hospital (HPTU) in Medellín, Colombia, between January 2017 and November 2023 and who presented neurological complications (NC) in the first thirty days after LT; compared to those patients who underwent LT during the same period and who did not present NC. Methodology. 165 adults (100 men and 65 women) were included. Among those who presented NC, the clinical manifestations, abnormal findings on physical examination, whether or not they had hyponatremia or hypomagnesemia at the time of the NC presentation, results of diagnostic aids, treatment received and whether or not they were evaluated by neurology are described. Results. 19 patients (11.5%) presented some CN in the first month post-transplant, with encephalopathy being the most frequent, with 9 cases (47.4%). Having a history of hepatic encephalopathy or mental or neurological disease in the pre-transplant period was statistically significantly associated with developing NC in the post-transplant period, as was Child C stage of liver disease, INR values ≥ 1,5 and low fibrinogen levels in the pre-transplant period, the indication for transplantation due to acute liver failure, urgent or non-elective indication for transplantation and the administration of basiliximab. Conclusions. These results provide a basis for risk stratification in patients who will undergo LT and for closer monitoring of those patients at risk of developing NC in the post-transplant period.