Transplant International (Feb 2024)

Clinical Impact and Risk Factors of Seizure After Liver Transplantation: A Nested Case-Control Study

  • Minyu Kang,
  • Hwa-Hee Koh,
  • Deok-Gie Kim,
  • Seung Hyuk Yim,
  • Mun Chae Choi,
  • Eun-Ki Min,
  • Jae Geun Lee,
  • Myoung Soo Kim,
  • Dong Jin Joo

DOI
https://doi.org/10.3389/ti.2024.12342
Journal volume & issue
Vol. 37

Abstract

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Seizures are a frequent neurological consequence following liver transplantation (LT), however, research on their clinical impact and risk factors is lacking. Using a nested case-control design, patients diagnosed with seizures (seizure group) within 1-year post-transplantation were matched to controls who had not experienced seizures until the corresponding time points at a 1:5 ratio to perform survival and risk factor analyses. Seizures developed in 61 of 1,243 patients (4.9%) at median of 11 days after LT. Five-year graft survival was significantly lower in the seizure group than in the controls (50.6% vs. 78.2%, respectively, p < 0.001) and seizure was a significant risk factor for graft loss after adjusting for variables (HR 2.04, 95% CI 1.24–3.33). In multivariable logistic regression, body mass index <23 kg/m2, donor age ≥45 years, intraoperative continuous renal replacement therapy and delta sodium level ≥4 mmol/L emerged as independent risk factors for post-LT seizure. Delta sodium level ≥4 mmol/L was associated with seizures, regardless of the severity of preoperative hyponatremia. Identifying and controlling those risk factors are required to prevent post-LT seizures which could result in worse graft outcome.

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