A new side effect of immunosuppression: High incidence of hearing impairment after liver transplantation.

February 10, 2006

Liver Transplant 2006 Feb 2 [Epub

ahead of print]

A

new side effect of immunosuppression: High incidence

of hearing impairment after liver transplantation.

Depart Gastroenterology,

Hepatology, & Endocrinology, Hannover, Germany.

Little is known about hearing impairment in patients after organ transplantation.

We conducted a single-center study to evaluate hearing

impairment in patients after orthotopic liver

transplantation (OLT). A questionnaire was sent to 695 adult patients after OLT

to assess characteristics and course of auditory impairment. Risk factors such

as ototoxic drugs were taken into consideration.

Clinical follow-up, including immunosuppressive therapy, was analyzed in

detail. The questionnaire was completed by 521 patients (75%). Hearing

impairment was reported by 184 patients (35%). A total of 43 patients (8%)

suffered from hearing abnormalities prior to OLT. The remaining 141 patients

(27%) developed hearing impairment after transplantation. Main problems were

hearing loss (52%), tinnitus (38%), and otalgia

(30%). There was no association of post-OLT hearing disorders with age or known

risk factors. In 43% of patients, onset of hearing impairment was within 2 yr

post-OLT. Hearing loss was positively associated with tacrolimus

immunosuppression in univariate

(P < 0.05) and multivariate analysis (P < 0.02). Patients using a hearing

aid received tacrolimus more frequently than

cyclosporine (P < 0.05). In

conclusion, subjective hearing impairment is frequent in patients after OLT and

contributes to post-OLT morbidity. Calcineurin

inhibitor-related neurotoxicity appears as a possible

mechanism. Further prospective investigations with objective hearing tests are

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Barb

in Texas - Together in the Fight, Whatever it Takes!

Son

Ken (31) UC 91 PSC99

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