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Encephalopathy in Liver Transplantation: Neuropathology and CMV Infection

Published online by Cambridge University Press:  18 September 2015

C. Power ,
S.D. Poland ,
K.H. Kassim ,
J.C.E. Kaufmann  and
G.P.A. Rice
C. Power
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
S.D. Poland
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
K.H. Kassim
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
J.C.E. Kaufmann
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
G.P.A. Rice*
Affiliation:
Department of Clinical Neurological Sciences, University of Western Ontario, London
*
University Hospital, 339 Windermere Road, London, Ontario, Canada N6A 5A5
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Abstract:

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The clinical histories and pathological findings of 27 autopsied cases of orthotopic liver transplantation (OLT) were reviewed. Fatal OLT was complicated in 93% of cases by neurological dysfunction, usually manifested by encephalopathy, with or without seizures. The etiology of the encephalopathy was largely multifactorial (44%) or undetermined (20%). Subarachnoid hemorrhage, central pontine myelinolysis, meningitis, brain infarction, polyclonal B cell lymphoma and spinal cord necrosis were common neuropathological findings. These diagnoses were often masked by other systemic illnesses. The role of cytomegalovirus (CMV) in neurologic dysfunction was explored with in situ hybridization and immunohistochemical techniques. OLT cases showed a significantly higher (89%) frequency of CMV genomic material in brain tissue compared to age-matched non immunocompromised (NIC) patients (23%). All OLT cases with encephalopathy of undetermined cause demonstrated unusually prominent hybridization to the CMV probe. CMV may be an important cause of encephalopathy in such patients.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 17 , Issue 4 , November 1990 , pp. 378 - 381
Copyright
Copyright © Canadian Neurological Sciences Federation 1990

References

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