Abstract | BACKGROUND: A prolonged survival in liver transplant recipients due to a better management exposes them to multiple factors that can impair neurologic function in the long term. METHODS: Twenty-two patients were studied by brain magnetic resonance and completed a neuropsychologic assessment shortly before liver transplant, 6 to 12 months after (short term), and 6 to 9 years (long term) after liver transplant. Thirteen healthy controls matched by age were studied in parallel. RESULTS: An enlargement in the ventricular size (an indirect measure of brain volume) was observed in the short term (+8%) and in the long term after liver transplant (+22%); the size of ventricles was larger than in healthy controls. In addition, a progression in the volume of focal T2 white matter lesions (an index of small vessel cerebrovascular disease) was detected in the long term (+49%) and was related to vascular risk factors in those with larger increases (>12.5% per year). Neuropsychologic function showed a significant improvement after liver transplant and remained stable in the long term, except for memory loss in those patients with larger increases in white matter lesions. CONCLUSIONS: Improvement in neuropsychologic function after successful liver transplant can be demonstrated up to 9 years. However, these patients experience a progressive accumulation of focal T2 brain lesions and show a smaller brain volume than controls, which can be related to their previous cirrhosis. A good management to minimize brain injury before transplantation and an accurate treatment of vascular risk factors may be important to prevent consequences on cognitive function.
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Authors | Rita García Martínez, Alex Rovira, Juli Alonso, F Xavier Aymerich, Elena Huerga, Carlos Jacas, Macarena Simón-Talero, Víctor Vargas, Juan Córdoba |
Journal | Transplantation
(Transplantation)
Vol. 89
Issue 5
Pg. 589-94
(Mar 15 2010)
ISSN: 1534-6080 [Electronic] United States |
PMID | 20118844
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Brain
(anatomy & histology)
- Carcinoma, Hepatocellular
(surgery)
- Cerebral Ventricles
(anatomy & histology)
- Female
- Follow-Up Studies
- Humans
- Liver Cirrhosis
(surgery)
- Liver Failure
(surgery)
- Liver Neoplasms
(surgery)
- Liver Transplantation
(physiology, psychology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neuropsychological Tests
- Organ Size
- Postoperative Period
- Reference Values
- Time Factors
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