Laura Tortolero,Javier  Nuño,Patricia  Luengo,Luis  Gajate,Adolfo  Buenadicha,Ana  Serrano,Fernando  Liaño,Roberto  Peromingo,Pedro  López Hervás,
Neurological Complications after Liver Transplantation According to Immunosuppressive Therapy
Neurology and Neurobiology
2020
2613-7828
http://dx.doi.org/10.31487/j.NNB.2020.02.14
https://www.sciencerepository.org/neurological-complications-after-liver-transplantation-according-to-immunosuppressive-therapy_NNB-2020-2-114 
Abstract: Background: Neurological complications (NC) after liver transplantation (LT) are frequent, appearing in
up to 60% of patients. Etiology is often related to immunosuppressant neurotoxicity and opportunistic
infections. The use of basiliximab allows for less toxic immunosuppressive therapies. The aim of this study
was to evaluate the neurological complications present during the first 30 days after LT and to evaluate its
relationship with renal function, immunosuppressive therapy, and mortality.
Methods: A total of 231 recipients were included in the retrospective, longitudinal, and nonrandomized
study under 2 different immunosuppression protocols (with -group B- or without basiliximab -group A-).
Results: NC were present in 14.3% of patients (n: 33), the average age of these patients was 55.4 years. The
incidence of NC was significantly higher in group A than in group B (19.5% vs. 9.3% p <0.05), with no
differences in the incidence of infection or rejection between both groups. The incidence of acute renal
failure, the need for renal replacement therapy, the days of admission to the ICU, the days of hospital
admission, as well as mortality during admission and one year after LT were higher among patients with
NC. However, when analyzing patients with a neurological complication, patients in group A had a higher
incidence of complications than in group B.
Conclusion: The use of immunosuppressive therapies that apply lower doses of anticalcineurinics and with
a later onset, classically called nephroprotective as used in group B, could also be neuroprotective, reducing
the appearance of neurological complications and, therefore, morbidity. These findings most be verified in
studies with a larger number of patients and randomized.Keywords: Neurological complication, liver transplantation, immunosuppressive therapy, basiliximab, anticalcineurinics, neurotoxicity