Abstract Details

Title Seizures After Liver Transplant

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) Epilepsy/Clinical Neurophysiology (EEG) Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 090

Objective To ascertain the prevalence of epileptic seizures in the postoperative period of adult liver transplantation and to describe the perioperative variables

Background Post-liver transplantation seizures are the second cause of neurological complications. Multiple etiologies underlie the problem

Design/Methods Retrospective descriptive observational study of electronic medical records of adult patients who suffered from a seizure up to 30 days after liver transplantation, between January 2009-December 2019. We collected demographic and surgery variables, clinical and neurological backgrounds, liver diseases history and acute determinants of epileptic seizures, and annual survival also

Results 377 adult patients underwent liver transplantation, 38 presented epileptic seizures (10.07%), 57.8% male, 60 years old (IQR 45-66). 78.38% had chronic liver failure, mainly due to alcohol and hepatitis C virus (38.3%), and non-alcoholic hepatic steatosis (14.8%). 7 had previous epilepsy. Postoperative sodium differential was -5.21mEq/L (SD 6.25), 6 recorded a variation >10mEq/l. Emergency transplantation was less frequent (21%). Surgery lasted 410 min (IQR 330-540), with vasopressor requirements (72.2%), red blood cells (81%) platelets (45.9%); requiring early surgery of 36.8%. Most common immunosuppression was steroids (94.5%), tacrolimus (86.4%), mycophenolate (60.5%). One week after transplantation (IQR 5-13), 12 non-convulsive epileptic status was observed, 2 convulsive, 11 isolated seizures and 13 electroencephalographic. Systemic complications: 24 new infections, 20 graft complications (failure, rejection, thrombosis, bleeding, biliary complication) and 14 severe electrolyte alterations (hyponatremia <115mEq/L, hypomagnesemia <0.8mg/dl, hypocalcemia <1.20mM 5mg/dl, glycemia <36 mg/dl). 28.5% had pathological neuroimaging, 3 pontine/extrapontine osmotic demyelination, 4 ischemia/bleeding and 3 ictal changes. 63.1% were medicated with levetiracetam, 3 underwent an intrahospital switch due to adverse effects (irritability). An annual survival rate of 86.8% was recorded (with follow-up of 81.82%)

Conclusions In our study, along 10 years, 1 in 10 liver transplant patients developed epileptic seizures, mostly in the context of severe systemic disorders. Our annual survival was similar to literature (79%)

Authors/Disclosures
Franco E. Appiani, MD (ACE Alzheimer Cente - Instituto Catalán de Neurociencias Aplicadas) PRESENTER	Dr. Appiani has nothing to disclose.
	No disclosure on file
Carla F. Bolano Diaz, MD (John Walton Muscular Dystrophy Research Centre)	Dr. Bolano Diaz has nothing to disclose.
Guido D. Vazquez II, PhD (Neurociencias Favaloro)	Dr. Vazquez has nothing to disclose.
santiago Claverie	santiago Claverie has nothing to disclose.
Ricardo D. Bernater	No disclosure on file
Analia Calle	Analia Calle has nothing to disclose.
	No disclosure on file
Veronica Campanille, MD	No disclosure on file
Alejandro Thomson, MD (Fundacion Favaloro)	Dr. Thomson has nothing to disclose.
Alfredo Thomson, MD (Favaloro Foundation)	Dr. Thomson has nothing to disclose.

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Abstract Details