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

TY - JOUR

T1 - A new side effect of immunosuppression: high incidence of hearing impairment after liver transplantation.

AU - Rifai, Kinan

AU - Kirchner, Gabriele I

AU - Bahr, Matthias J

AU - Cantz, Tobias

AU - Rosenau, Jens

AU - Nashan, Björn

AU - Klempnauer, Jürgen L

AU - Manns, Michael P

AU - Strassburg, Christian P

PY - 2006

Y1 - 2006

N2 - 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 necessary to confirm these results and to evaluate the role of immunosuppression.

AB - 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 necessary to confirm these results and to evaluate the role of immunosuppression.

M3 - SCORING: Zeitschriftenaufsatz

VL - 12

SP - 411

EP - 415

JO - LIVER TRANSPLANT

JF - LIVER TRANSPLANT

SN - 1527-6465

IS - 3

M1 - 3

ER -