Seizures in Pediatric Patients With Liver Transplant and Efficacy of Levetiracetam

2017 ◽  
Vol 32 (8) ◽  
pp. 740-745 ◽  
Author(s):  
Betül Kılıç ◽  
Serdal Güngör ◽  
Müjgan Arslan ◽  
Mukadder Ayşe Selimoğlu ◽  
Sezai Yılmaz
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Transplant Patient ◽  
Pediatric Patients ◽  
Laboratory Data ◽  
Specific Treatment ◽  
Transplant Recipients ◽  
Symptomatic Epilepsy ◽  
Common Risk Factors ◽  
New Onset

The aim of this study was to evaluate the risk factors, clinical implications, and prognosis of new-onset seizures that occurred after pediatric liver transplantation, and to assess the efficacy of levetiracetam treatment. The clinical and laboratory data of liver transplanted 28 children who had seizures after liver transplantation and specifically of 18 children who received levetiracetam were analyzed retrospectively. Sixteen patients (88.9%) remained seizure-free and in 2 (11.1%), more than 50% reduction in seizures were detected with levetiracetam treatment. In conclusion, seizures are generally the most common complication by a spectrum of seizure types, and sometimes cause symptomatic epilepsy. The most common risk factors for seizures in transplant recipients is immunosuppressant toxicity. Currently, there isn’t a specific treatment involving the transplant patient population. Levetiracetam may be preferable in pediatric patients as it’s reliable for liver disease and has advantages in the treatment of postoperative seizures due to its intravenous usage.

scholarly journals Risk factors predicting Cytomegalovirus infection in post liver transplant recipients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Abdelrahman ◽  
H A Mahmoud ◽  
M K Mohsen ◽  
M O Ali ◽  
A M N Mohamed
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Organ Transplantation ◽  
Chronic Rejection ◽  
Cytomegalovirus Infection ◽  
Transplant Recipients ◽  
Cmv Infection ◽  
Donor Liver Transplantation ◽  
Liver Transplant Recipients

Abstract Background Liver transplantation is considered to be the only curative treatment for patients with end stage liver disease. Postoperative infection remains to be one of the most common causes of morbidity and mortality throughout the past years. Cytomegalovirus (CMV) infection although considered to be a weak viral infection that usually passes asymptomatic in immunocompetent patients, however, it is considered one of the most common pathogens causing morbidities and mortality in liver transplant recipients. Multiple studies have been done to assess the risk factors for developing CMV infection. Objective Identification of risk factors predicting Cytomegalovirus infection in liver transplant recipients following transplantation. Methods This retrospective study was conducted on 194 patients and their donors who underwent living donor liver transplantation operation at Ain Shams centre for organ transplantation (ASCOT) at Ain Shams specialized hospital in the period between January 2010 and December 2016 with at least one year follow up period after operation for the recipient group. Results In our study, 194 patients undergoing liver transplantation at Ain shams centre for organ transplantation over seven years from January 2010 to December 2016 have been followed to assess risk factors affecting CMV infection development. Chronic rejection was found to be the most common factor associated with CMV infection followed by Cyclosporin (Neoral) as main postoperative immunosuppressant following liver transplantation. Other factors that were found to carry risk for CMV infection included younger age, advanced MELD score, positive CMV IgM status of the donors and recipients. Conclusion Differentiation of Cytomegalovirus disease from Cytomegalovirus infection isn’t always available as it requires tissue invasive techniques. Multiple risk factors have been attributed to cause Cytomegalovirus infection (viremia) . In our study, rejection (chronic rejection) was the factor that carries highest risk for Cytomegalovirus infection development followed by Cyclosporin .

scholarly journals An Analysis of the Risk Factors for New-Onset Diabetes Mellitus After Liver Transplantation

2021 ◽  
Vol Volume 14 ◽  
pp. 4783-4792
Author(s):  
Jushan Sun ◽  
Yibiao He ◽  
Lei Bai ◽  
Zhipeng Wang ◽  
Zhu Cao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Transplantation ◽  
Onset Diabetes ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Pleural Effusions Following Liver Transplantation: A Single-Center Experience

2020 ◽  
pp. 088506662093244
Author(s):  
Justin K. Lui ◽  
Lidia Spaho ◽  
Shahrad Hakimian ◽  
Michael Devine ◽  
Rosa Bui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Hospital Length Of Stay ◽  
Transplant Recipients ◽  
Single Center ◽  
Pleural Effusions ◽  
Post Transplantation ◽  
Significant Difference ◽  
Liver Transplant Recipients

Introduction: This was a single-center retrospective study to evaluate incidence, prognosis, and risk factors in patients with postoperative pleural effusions, a common pulmonary complication following liver transplantation. Methods: A retrospective review was performed on 374 liver transplantation cases through a database within the timeframe of January 1, 2009 through December 31, 2015. Demographics, pulmonary and cardiac function testing, laboratory studies, intraoperative transfusion/infusion volumes, postoperative management, and outcomes were analyzed. Results: In the immediate postoperative period, 189 (50.5%) developed pleural effusions following liver transplantation of which 145 (76.7%) resolved within 3 months. Those who developed pleural effusions demonstrated a lower fibrinogen (149.6 ± 66.3 mg/dL vs 178.4 ± 87.3 mg/dL; P = .009), total protein (5.8 ± 1.0 mg/dL vs 6.1 ± 1.2 mg/dL; P = .04), and hemoglobin (9.8 ± 1.8 mg/dL vs 10.3 ± 1.9 mg/dL; P = .004). There was not a statistically significant difference in 1-year all-cause mortality and in-hospital mortality between liver transplant recipients with and without pleural effusions. Liver transplant recipients who developed pleural effusions had a longer hospital length of stay (16.4 ± 10.9 days vs 14.0 ± 16.5 days; P = .1), but the differences were not statistically significant. However, there was a significant difference in tracheostomy rates (11.6% vs 5.4%; P = .03) in recipients who developed pleural effusions compared to recipients who did not. Conclusions: In summary, pleural effusions are common after liver transplantation and are associated with increased morbidity. Pre- and intraoperative risk factors can offer both predictive and prognostic value for post-transplantation pleural effusions. Further prospective studies will be needed to further evaluate the relevance of these findings to limit instances of postoperative pleural effusions.

Risk Factors for Premature Coronary Heart Disease after Successful Liver Transplantation in Adults

1996 ◽  
Vol 6 (4) ◽  
pp. 178-187
Author(s):  
Susan L Smith
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Liver Transplantation ◽  
Heart Disease ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Pharmacological Agents ◽  
Premature Coronary Heart Disease

As solid-organ transplantation has evolved into a highly effective treatment for end-stage organ disease, the long-term health implications of chronic exposure of recipients to immunosuppressants and other pharmacological agents are becoming more apparent. Coronary heart disease has long been known to plague kidney transplant recipients and more recently has been found to affect heart transplant recipients disproportionately. Coronary heart disease after liver transplantation, however, is less well known. The purpose of this study was to examine risk factors for premature coronary heart disease in asymptomatic adult recipients of liver transplants. Nutrition-related risk factors for coronary heart disease (obesity and hyperlipidemia) were measured in 29 patients before and after liver transplantation. Changes with respect to primary immunosuppression protocol (cyclosporine plus corticosteroid vs tacrolimus plus corticosteroid) were compared. Risk factors that had not been present before transplantation were apparent in both groups by 6 months after transplantation. Although obesity and hyperlipidemia were not found to be independent risk factors for coronary heart disease, they were clinically important when considered in combination. Cyclosporine was associated with significantly higher serum lipid concentrations than was tacrolimus.

New-Onset Cardiovascular Risk Factors in Lung Transplant Recipients

2005 ◽  
Vol 24 (10) ◽  
pp. 1536-1543 ◽  
Author(s):  
Martin Silverborn ◽  
Anders Jeppsson ◽  
Gunnar Mårtensson ◽  
Folke Nilsson
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lung Transplant ◽  
Transplant Recipients ◽  
Lung Transplant Recipients ◽  
New Onset

scholarly journals Infection within 2 weeks before liver transplantation closely related to prognosis of posttransplant infection: a single-center retrospective observational study in China

2019 ◽  
Author(s):  
Yue Ying ◽  
Rui-Dong Li ◽  
Jing-Wen Ai ◽  
Yi-Min Zhu ◽  
Xian Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Prognostic Factors ◽  
Liver Disease ◽  
Klebsiella Pneumoniae ◽  
Postoperative Infection ◽  
Transplant Recipients ◽  
Biliary Tract Infection ◽  
End Stage Liver Disease ◽  
End Stage

Abstract Background Infections still represent the main factors influencing morbidity and mortality following liver transplantation. This study is to evaluate the incidence and risk factors for infection and survival after liver transplantation. Methods We retrospectively examined medical records in 210 recipients who underwent liver transplantation between April 2015 and October 2017 in our center. Results During the median follow-up days of 214, the incidence of infection after liver transplantation was 46.7% (n=98): namely, pneumonia (43.4%), biliary tract infection (21.9%) and peritonitis (21.4%). Among the pathogens in pneumonia, the most frequently isolated was Acinetobacter baumanii (23.5%) and Klebsiella pneumoniae (21.1%). For biliary tract infection, the first rank was Strenotrophomonas maltophilia (14.0%) and then Klebsiella pneumoniae (11.6%). Pseudomonas aeruginosa, Strenotrophomonas maltophilia, and Klebsiella pneumoniae accounted for 21.4%, 11.9% and 11.9% of pathogens in peritonitis, respectively. The independent risk factors for infection after liver transplantation are model for end-stage liver disease (MELD) or pediatric end-stage liver disease (PELD) score, total blood loss in operation and duration of drainage tube. All-cause mortality was 11.0% (n=23). The prognostic factors for postoperative infection in transplant recipients are infection, especially pneumonia within 2 weeks before transplantation, complication with impaired renal function and higher MELD or PELD score after 7 days of transplantation. Kaplan–Meier curves of survival showed that recipients with infection within 2 weeks before transplantation had a significantly lower cumulative survival rate compared with those without infection (66.7% vs 91.9%, HR=4.480, 95% CI, 3.377-47.85; p<0.001). Conclusions Infection, especially pneumonia within 2 weeks before transplantation are independent prognostic factors for postoperative infection in transplant recipients.

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