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 18 November 2017

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News

Neuropsychologic dysfunction after liver transplantation for acute liver failure

Researchers from the University of North Carolina at Chapel Hill, USA, suggest that patients with acute liver failure may experience greater neuropsychologic dysfunction after transplant, than those with chronic liver disease.

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Several studies have identified posttransplant neurologic sequelae in patients with acute liver failure (ALF), however the effects of these sequelae on neuropsychologic functioning after transplant is unknown.

In this study, published in the latest issue of Liver Transplantation, researchers compared neuropsychologic functioning of ALF patients with chronic liver disease (CLD) patients, after liver transplantation.

Following liver transplantation, 7 ALF patients were compared with a matched control group of patients who had been transplanted for CLD. The researchers matched the patients by gender, age, and time since transplantation.

The patients then completed a 2-hour battery of tests. These included measures of attention, memory, motor performance, abstract conceptualization, and visuospatial perception.

The research team found no significant differences between the groups on measures of socioeconomic status or education.

Nearly all patients complained of memory difficulties since transplantation.
Liver Transplantation

However, significant differences were found on three separate tests: WAIS-III Vocabulary, WAIS-III Similarities, and WMS-III Paired Associate Learning II.

These tests measure distinct functions (vocabulary knowledge, abstract conceptualization, and delayed verbal recall), but may be influenced by broader verbal functions, such as verbal fluency, conceptualization, and the ability to articulate ideas.

When patients were asked what functions had noticeably deteriorated since transplantation, nearly all complained of memory difficulties, and there was no difference between groups.

However, the researchers found that more ALF than CLD patients complained of concentration difficulties.

Dr Elizabeth Jackson's team concluded, "The results of this study suggest that ALF patients may experience more neuropsychologic dysfunction after transplant".

"Further studies are required to expand on these initial observations with the potential to improve patient care and referral to appropriate rehabilitative services".

Liver Transpl 2002; 8: 932-6
17 October 2002

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