Both deceased donor Liver Transplantation (DDLT) and living-donor Liver Transplantation (LDLT) are being successfully performed at King Faisal Specialist Hospital and Research Center (KFSH&RC). Herein we present our experience with Dermatological Complication following Liver Transplantation (LT).
Patients and Method: At KFSH&RC, and between April 2001 and August 2006, a total of 106 LT procedures were performed (63 DDLTs and 43 LDLTs) in 102 patients (4 re-transplants). Most recipients received FK506 and steroid based immunosuppression regimen, while few received Cyclosporine. Steroid were gradual withdrawn in most patients except those transplanted for autoimmune hepatitis.
Results: Out of 102 LT recipients, 13 patients (12.7%) had dermatological complications, they included; epidermolysis bullosa acquisita in one patient with hepatitis C who showed significant skin fragility and blistering occurring both spontaneously and at the site of trauma, he was treated conservatively and required no further intervention; Kaposi's sarcoma in one patient treated with surgical excision and conversion to Sirolimus-based immunosuppression regimen; drug-induced cutaneous vasculitis with deep ulcer formation on the inner thigh treated by drug discontinuation and surgical excision of the ulcer and reconstruction of the skin defect; herpes zoster in one patients treated with intravenous antiviral therapy; herpes simplex in 2 patients treated with local antiviral cream; Cyclosporine-induced gingival hyperplasia treated with conversion to FK506; Cyclosporine-induced hypertrichosis treated with conversion to FK506; steroid-induced skin hyperpigmentation in one patient treated with steroids withdrawal; hypomagnesemia-induced hair loss treated with daily magnesium supplement; pressure-induced alopecia areata in 2 patients that was self-limiting and required no treatment; finally, one patient suffered from heel pressure ulcer that was treated by frequent dressing and required no further intervention. In 8 out of 13 patients (62%) who suffered from dermatological problem, the complication was primarily related to immunosuppressive medications. In our experience, dermatological complications following LT are not uncommon and they are usually related to immunosuppressive drugs. Most of those complications could be prevented by optimization of immunosuppression, and moreover, the majority of those complications could be easily treated by simple adjustment of immunosuppression.