Severe acute polyneuropathy complicating orthotopic liver allograft failure

Neuromuscular dysfunction complicating orthotopic liver transplantation (OLT) has rarely been described. We report three cases of severe acute motor deficit after OLT in a context of graft dysfunction.

From December 1999 to December 2000, the muscle strength of all patients who underwent OLT in our hospital was checked during their stay in the intensive care unit. Patients having a severe motor deficit underwent electrophysiological examination within 2 weeks after the onset of deficit.

Three patients developed acute quadriplegia concomitant with early allograft failure in a series of 30 patients. In these three patients, electrophysiological signs of sensorimotor axonal polyneuropathy were found. No sepsis was observed; hepatic failure, together with acute renal insufficiency in two cases, was the only risk factor identified for critical illness neuropathy.

The physicians who take charge of patients after OLT must be aware of the possible occurrence of severe polyneuropathy in case of early allograft dysfunction.