Two Cases With Developing Neurologic Complications After Liver Transplant.

Area of Science:

• Nephrology
• Neurology
• Immunology

Background:

• Immunosuppressive agents, particularly cyclosporine and tacrolimus, are vital for successful solid-organ and stem cell transplants.
• These medications, while essential, carry a risk of adverse effects, including neurological complications.

Observation:

• Two liver transplant patients developed significant neurological symptoms: epileptic seizures with hemiparesis and delirium.
• These symptoms were suspected to be related to posterior reversible encephalopathy syndrome due to cyclosporine toxicity.

Findings:

• In both cases, neurological symptoms resolved following a decrease in blood cyclosporine levels.
• This suggests a direct link between cyclosporine toxicity and the observed neurological complications.

Implications:

• Neurological complications are common post-liver transplant, often appearing within the first month.
• Prompt identification and management of immunosuppressive drug toxicity, such as cyclosporine-induced encephalopathy, are critical for successful patient outcomes.
• Addressing the underlying cause, like drug toxicity, can lead to significant clinical and radiological improvement.