Correlation between serum magnesium levels and hepatic encephalopathy in immediate post liver transplantation period

Liver transplantation is a complex procedure that interferes with multiple body functions and can cause several complications. Studies have shown varying incidences of neurological complications (8% to 47%) including encephalopathy, as well as cerebrovascular problems, infections, and neurotoxicity induced by immunosuppressive drugs. The majority of these cases occur in the first week after surgery.

We sought to evaluate the correlation between serum magnesium levels and the development of encephalopathy in the immediate posttransplantation period.

We collected data from patients undergoing liver transplantation, both donors and recipients, from 2007 to 2009. Magnesium levels during the first week of hospitalization were compared to reference laboratory results. The West Haven criteria were used to classify whether if the patient experienced encephalopathy.

Only the level of magnesium posttransplantation represented a risk for encephalopathy (P = .049). Lower magnesium levels increased the risk of encephalopathy (relative risk = 3.718; 95% confidence interval: 1.001-13.699).

We verified the importance of low levels of magnesium as a predictive factor to increase the occurrence of encephalopathy after liver transplantation.