Hassan Nadeem, Muhammad Omer Farooq, Niaz Muhammad, Kashif Rafi, Asmat Ullah, Sadia Jabbar

Frequency of Hepatic Encephalopathy in Post liver Transplant Patients

Hassan Nadeem, Muhammad Omer Farooq, Niaz Muhammad, Kashif Rafi, Asmat Ullah, Sadia Jabbar



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ABSTRACT

Objective: The objective of this study was to determine the frequency of hepatic encephalopathy in post liver transplant patients at a tertiary care hospital in Punjab.

Study Design: It was a descriptive case series.

Setting: Research was conducted at Department of Gastroenterology, Shaikh Zayed Hospital Lahore.

Duration: Duration of study was 6 months after the approval of synopsis from 05/08/2017 to 04/02/2018.

Material and Methods: This study involved 139 patients of both genders aged between 30-70 years diagnosed of chronic liver disease and undergoing liver transplantation. Patients were followed in the post-transplant period and hepatic encephalopathy was diagnosed using West Haven Criteria ≥Stage I during 4 weeks period after transplant. A written informed consent was obtained from every patient.

Results: The mean age of the patients was 48.1±8.6 years. Most of the patients were aged between 51-65 years (59.0%) followed by 35-50 years (41.0%). There were 90 (64.7%) male and 49 (35.3%) female patients in the study group with a male to female ratio of 1.8:1. Chronic hepatitis C was the most frequent underlying cause and was observed in 105 (75.5%) patients followed by chronic hepatitis B (12.9%) and autoimmune hepatitis (11.6%). Post-transplant hepatic encephalopathy was diagnosed in 17 (12.2%) patients. 10 (7.2%) patients had stage-I, 5 (3.6%) patients had stage-II and 2 (1.4%) patients had stage-III encephalopathy. There was no significant difference in the frequency of post-transplant hepatic encephalopathy across age (p-value=0.988), gender (p-value=0.997) and underlying cause (p-value=0.714).

Conclusion: Hepatic encephalopathy was observed in a substantial proportion of patients undergoing liver transplantation for chronic liver disease which warrants routine monitoring of such patients in the post-operative period so that timely identification and management can improve the outcome among such cases.

Keywords: Chronic Liver Disease, Liver Transplant, Hepatic Encephalopathy



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