Cargando…
Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience
Background: Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predict...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954213/ https://www.ncbi.nlm.nih.gov/pubmed/35324575 http://dx.doi.org/10.3390/neurolint14010019 |
_version_ | 1784676039315685376 |
---|---|
author | Avorio, Federica Sparacia, Gianvincenzo Russelli, Giovanna Seidita, Aurelio Mamone, Giuseppe Alduino, Rossella Tuzzolino, Fabio Gruttadauria, Salvatore Miraglia, Roberto Bulati, Matteo Lo Re, Vincenzina |
author_facet | Avorio, Federica Sparacia, Gianvincenzo Russelli, Giovanna Seidita, Aurelio Mamone, Giuseppe Alduino, Rossella Tuzzolino, Fabio Gruttadauria, Salvatore Miraglia, Roberto Bulati, Matteo Lo Re, Vincenzina |
author_sort | Avorio, Federica |
collection | PubMed |
description | Background: Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predicts acute NCs in over 65-year-old liver transplant patients. Methods: Data were collected, from a retrospective medical chart review, of 22 deceased donor liver transplant recipients aged 65 years or older with a pre-operative brain magnetic resonance imaging (MRI). We used the Fazekas score (0–3) as a quantitative measurement of the vascular lesion load seen in the MRI. We analyzed all post-operative acute NCs occurring during the hospital stay and any other non-NC. Results: cSVD was recognized in all patients. Neurological complications (NCs) occurred in 18.1% of patients with toxic-metabolic encephalopathy the most frequent diagnosis (13.64%). More severe cSVD was associated with seizures (p = 0.0362), longer hospital stay (p 0.0299), and disability (p 0.0134). In our elderly cohort, hepatic encephalopathy (HE) (p 0.0287) and ascites (p 0.0270) were predictors of NCs after liver transplantation. Ascites and/or variceal bleeding and severity of liver disease were associated with adverse post-operative outcomes. The small sample size limited the statistical analysis power. Conclusions: We present the preliminary data of a single-center retrospective study aimed at understanding the cSVD role on NCs and non-NCs after a liver transplantation in elderly patients. This would encourage a more appropriate multicenter prospective study that will definitely confirm if a neurological screening in old age liver transplant candidates is appropriate. |
format | Online Article Text |
id | pubmed-8954213 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89542132022-03-26 Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience Avorio, Federica Sparacia, Gianvincenzo Russelli, Giovanna Seidita, Aurelio Mamone, Giuseppe Alduino, Rossella Tuzzolino, Fabio Gruttadauria, Salvatore Miraglia, Roberto Bulati, Matteo Lo Re, Vincenzina Neurol Int Article Background: Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predicts acute NCs in over 65-year-old liver transplant patients. Methods: Data were collected, from a retrospective medical chart review, of 22 deceased donor liver transplant recipients aged 65 years or older with a pre-operative brain magnetic resonance imaging (MRI). We used the Fazekas score (0–3) as a quantitative measurement of the vascular lesion load seen in the MRI. We analyzed all post-operative acute NCs occurring during the hospital stay and any other non-NC. Results: cSVD was recognized in all patients. Neurological complications (NCs) occurred in 18.1% of patients with toxic-metabolic encephalopathy the most frequent diagnosis (13.64%). More severe cSVD was associated with seizures (p = 0.0362), longer hospital stay (p 0.0299), and disability (p 0.0134). In our elderly cohort, hepatic encephalopathy (HE) (p 0.0287) and ascites (p 0.0270) were predictors of NCs after liver transplantation. Ascites and/or variceal bleeding and severity of liver disease were associated with adverse post-operative outcomes. The small sample size limited the statistical analysis power. Conclusions: We present the preliminary data of a single-center retrospective study aimed at understanding the cSVD role on NCs and non-NCs after a liver transplantation in elderly patients. This would encourage a more appropriate multicenter prospective study that will definitely confirm if a neurological screening in old age liver transplant candidates is appropriate. MDPI 2022-02-25 /pmc/articles/PMC8954213/ /pubmed/35324575 http://dx.doi.org/10.3390/neurolint14010019 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Avorio, Federica Sparacia, Gianvincenzo Russelli, Giovanna Seidita, Aurelio Mamone, Giuseppe Alduino, Rossella Tuzzolino, Fabio Gruttadauria, Salvatore Miraglia, Roberto Bulati, Matteo Lo Re, Vincenzina Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title | Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title_full | Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title_fullStr | Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title_full_unstemmed | Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title_short | Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience |
title_sort | neurological screening in elderly liver transplantation candidates: a single center experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954213/ https://www.ncbi.nlm.nih.gov/pubmed/35324575 http://dx.doi.org/10.3390/neurolint14010019 |
work_keys_str_mv | AT avoriofederica neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT sparaciagianvincenzo neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT russelligiovanna neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT seiditaaurelio neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT mamonegiuseppe neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT alduinorossella neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT tuzzolinofabio neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT gruttadauriasalvatore neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT miragliaroberto neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT bulatimatteo neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience AT lorevincenzina neurologicalscreeninginelderlylivertransplantationcandidatesasinglecenterexperience |