Neurologic complications following liver transplantation

Neurologic complications are very common following liver transplantation and appear in 30%-90% of the patients. These complications represent a wide array of etiologies, often presenting complicated diagnostic options. The primary liver disease for which the patient underwent the transplantation can cause neurologic complications, or they can be a presentation of a metabolic or vascular derangement. The medications given to liver transplanted patients can cause neurologic complication either directly via drug side effects or indirectly via immune-suppression and secondary opportunistic infections of the nervous system. We present two cases of liver transplanted patients, one suffering from a complex neurologic syndrome attributed to her primary Wilsons disease and the second with recurrent encephalopathy following transplantation attributed to a porto-systemic shunt. We review the current literature on the subject.