Àá½Ã¸¸ ±â´Ù·Á ÁÖ¼¼¿ä. ·ÎµùÁßÀÔ´Ï´Ù.
KMID : 1141320180330010096
Kosin Medical Journal
2018 Volume.33 No. 1 p.96 ~ p.104
Fatal neurological complication after liver transplantation in acute hepatic failure patient with hepatic encephalopathy
Kim Joo-Yun

Ri Hyun-Su
Yoon Ji-Uk
Choi Eun-Ji
Kim Hye-Jin
Park Ju-Yeon
Abstract
Liver transplantation is a current definitive treatment for those with end-stage liver disease. Hepatic encephalopathy is a common complication of hepatic failure, which can be improved and aggravated by various causes. It is important to differentiate hepatic encephalopathy from other diseases causing brain dysfunction such as cerebral hemorrhage, which is also related to high mortality after liver transplant surgery. A 37-year-old patient was presented with acute liver failure and high ammonia levels and seizure-like symptoms. Computed tomography (CT) of his brain showed mild brain atrophy, regarded as a symptom of hepatic encephalopathy, and treated to decrease blood ammonia level. Deceased donor liver transplantation was performed and liver function and ammonia level normalized after surgery, but the patient showed symptoms of involuntary muscle contraction and showed loss of pupil reflex and fixation without recovery of consciousness. Brain CT showed brain edema and bilateral cerebral infarction, and the patient died after a few days. The purpose of this case report is to emphasize the importance of preoperative neurological evaluation, careful transplantation decision, and proper perioperative management of liver transplantation in patients with acute hepatic encephalopathy.
KEYWORD
Acute Hepatic Failure, Brain edema, Hepatic encephalopathy, Liver Transplantation, Seizure
FullTexts / Linksout information
Listed journal information
ÇмúÁøÈïÀç´Ü(KCI) KoreaMed