Possible therapeutic effect of lipid supplementation on neurological complications in liver transplant recipients

Transpl Int. 2007 Jul;20(7):632-5. doi: 10.1111/j.1432-2277.2007.00487.x. Epub 2007 Apr 18.

Abstract

Neurological complications (NCs) represent a serious problem following liver transplantation and may develop either because of various peri-operative factors or the toxicity of immunosuppression. Although the causality assessment of NCs can be particularly difficult in the setting of organ transplantation, calcineurin inhibitors (CNIs) might influence NCs to a certain extent, regardless of the etiology. Therefore, minimizing the influence of CNIs could be a reasonable strategy for alleviating NCs. Based on our hypothesis that lipid supplementation prevents lipophilic CNIs from crossing the blood-brain barrier, soybean oil was administered to five liver transplant patients with NCs. In all of these patients, the neurological symptoms improved without discontinuing or reducing the dose of CNIs. Thus, lipid supplementation might be able to reduce the adverse neurological effects of CNIs.

MeSH terms

  • Adult
  • Aged
  • Blood-Brain Barrier*
  • Calcineurin Inhibitors*
  • Cyclosporine / adverse effects
  • Cyclosporine / antagonists & inhibitors
  • Cyclosporine / metabolism
  • Cyclosporine / therapeutic use
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / antagonists & inhibitors*
  • Immunosuppressive Agents / metabolism
  • Immunosuppressive Agents / therapeutic use
  • Liver Transplantation*
  • Male
  • Middle Aged
  • Nervous System Diseases / chemically induced*
  • Nervous System Diseases / prevention & control*
  • Soybean Oil / therapeutic use*
  • Tacrolimus / adverse effects
  • Tacrolimus / antagonists & inhibitors
  • Tacrolimus / metabolism
  • Tacrolimus / therapeutic use

Substances

  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Soybean Oil
  • Cyclosporine
  • Tacrolimus