EVIDENCE LIBRARY
Liver-Transplant Catatonia Cases Responded to Lorazepam Without Proving Immunosuppressant Toxicity
Two reports described rapid response to intravenous lorazepam after transplantation. Treatment response supported a clinical syndrome while leaving its cause uncertain.
Two reports described rapid response to intravenous lorazepam after transplantation. Treatment response supported a clinical syndrome while leaving its cause uncertain.
The differential diagnosis
The authors described catatonia in two liver-allograft recipients and reviewed other transplant reports. Potential alternatives included delirium, nonconvulsive seizures, drug toxicity, and other explanations for reduced responsiveness.
The cases improved with lorazepam. The authors proposed that recognizing the syndrome could sometimes avoid reflexively changing immunosuppressant treatment.
Response is not an exclusive mechanism test
A benzodiazepine response does not establish that one transplant medicine caused catatonia or exclude every concurrent condition. Two selected cases cannot estimate incidence or compare treatment strategies reliably.
The report supports careful bedside assessment and reconstruction of the clinical course. It cannot establish a universal rule to retain or stop immunosuppression. Forensic summaries should separate the documented syndrome, diagnostic alternatives, medication timing, and observed response rather than treating all postoperative immobility as one toxic effect.
Source paper
Original analysis of the supplied journal article, identified as PMC6248284.