Patients after orthotopic liver transplantation may show cognitive dysfunction.
To date, it has not been clear whether this dysfunction is due to residual hepatic encephalopathy or new-onset cognitive disturbances.
Just as little is known about the course and clinical significance.
Dr Anita Blanka Tryc and colleagues from Germany performed a prospective, observational study of 50 patients on the waiting list for orthotopic liver transplantation.
The patients were examined in an outpatient setting before orthotopic liver transplantation, and 6 and 12 months after orthotopic liver transplantation with the Psychometric Hepatic Encephalopathy Score, the Inhibitory Control Test, and the critical flicker frequency for the diagnosis of hepatic encephalopathy.
In addition, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used as a tool for the measurement of global cognitive function.
|Approximately 70% of the patients deteriorated in at least 1 cognitive domain |
The Short Form 36 health survey was used to assess health-related quality of life.
The team observed that 12 months after orthotopic liver transplantation, cognitive dysfunction characteristic of hepatic encephalopathy had resolved, but a secondary cognitive decline became apparent and had features different from those known with hepatic encephalopathy.
Approximately 70% of the patients deteriorated in at least 1 cognitive domain of RBANS.
The research team noted that this cognitive decline was related to neither a history of hepatic encephalopathy nor a history of alcohol abuse, but it was accompanied by a decline in the quality of life.
Dr Tryc's team concludes, "Orthotopic liver transplantation improves hepatic encephalopathy but is frequently followed by new-onset cognitive dysfunction, which can interfere with the quality of life."