Cognitive Function in Liver Transplantation
- PMID: 32435574
- PMCID: PMC7223312
- DOI: 10.1007/s40472-020-00274-2
Cognitive Function in Liver Transplantation
Abstract
Purpose of review: Liver transplantation (LT) remains the only way to cure patients with severe liver diseases. Important questions about neurological sequelae and quality of life after LT have emerged. In this review, we discuss the neurocognitive changes associated with LT and we conclude with recommendations in this regard for patients, caregivers, and physicians.
Recent findings: Compared with other solid organ recipients, LT patients tend to have a higher incidence (up to 30%) of neurological complications post-LT. Even in absence of previous episodes of hepatic encephalopathy (HE), some patients display new onset of neurological symptoms post-LT, raising the concern about the role of other factors that may have a direct impact on cognitive function.
Summary: Different mechanisms have been postulated to explain these postoperative neurological symptoms. They include sequelae of HE, persistent impairment of cognitive function due to cirrhosis, or postoperative decompensation of an unknown or undiagnosed neurodegenerative disorder.
Keywords: Brain function; Cirrhosis; Cognition; Cognitive reserve; Transplant.
© Springer Nature Switzerland AG 2020.
Conflict of interest statement
Conflict of InterestDr. Albhaisi has no conflict of interest. Dr. Bajaj has served on Advisory boards for Norgine and Merz and his institution received research grants from Grifols and Valeant Pharmaceuticals.
Figures
References
-
- Kappus MR, Bajaj JS. Covert hepatic encephalopathy: not as minimal as you might think. Clin Gastroenterol Hepatol. 2012;10:1208–1219. - PubMed
-
- Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721. - PubMed
-
- Poordad FF. Review article: the burden of hepatic encephalopathy. Aliment Pharmacol Ther 2007;25 Suppl 1:3–9. - PubMed
-
- Ortiz M, Jacas C, Córdoba J. Minimal hepatic encephalopathy: diagnosis, clinical significance and recommendations. J Hepatol. 2005;42 Suppl:S45–S53. - PubMed
-
- Bajaj JS, Hafeezullah M, Franco J, Varma RR, Hoffmann RG, Knox JF, et al. Inhibitory control test for the diagnosis of minimal hepatic encephalopathy. Gastroenterology. 2008;135:1591–1600.e1. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Research Materials