Abstract
Liver transplantation (LT) is the definitive treatment for liver failure and its associated complications including hepatic encephalopathy (HE). LT is known to improve survival, quality of life (QOL), and cognitive functioning in patients with HE. Some authors have reported resolution of severe forms of neurodegeneration such as acquired hepatocerebral degeneration after LT. Overt HE is known to resolve after LT, whereas the improvement in minimal HE appears to be dynamic, nonhomogenous, and at times incomplete. There are a range of possible reasons for persistent cognitive deficits after LT. Possible lasting effect of overt HE on brain is one of them. Overt HE is also known to affect the post-LT survival, QOL, and modulate early calcineurin inhibitor-induced neurotoxicity. As detrimental effects of overt HE on transplant outcomes become more apparent, more emphasis might need to be given for early transplantation in these patients.
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References
Hockerstedt K, Kajaste S, Isoniemi H, Muuronen A, Raininko R, Seppalainen AM, et al. Tests for encephalopathy before and after liver transplantation. Transplant Proc. 1990;22(4):1576–8.
Moore KA, McL Jones R, Burrows GD. Quality of life and cognitive function of liver transplant patients: a prospective study. Liver Transpl. 2000;6(5):633–42.
Tarter RE, Switala J, Plail J, Havrilla J, Van Thiel DH. Severity of hepatic encephalopathy before liver transplantation is associated with quality of life after transplantation. Arch Intern Med. 1992;152(10):2097–101.
Stracciari A, Guarino M, Pazzaglia P, Marchesini G, Pisi P. Acquired hepatocerebral degeneration: full recovery after liver transplantation. J Neurol Neurosurg Psychiatry. 2001;70(1):136–7.
Stracciari A, Baldin E, Cretella L, Delaj L, D’Alessandro R, Guarino M. Chronic acquired hepatocerebral degeneration: effects of liver transplantation on neurological manifestations. Neurol Sci. 2011;32(3):411–5.
Powell EE, Pender MP, Chalk JB, Parkin PJ, Strong R, Lynch S, et al. Improvement in chronic hepatocerebral degeneration following liver transplantation. Gastroenterology. 1990;98(4):1079–82.
Pinarbasi B, Kaymakoglu S, Matur Z, Akyuz F, Demir K, Besisik F, et al. Are acquired hepatocerebral degeneration and hepatic myelopathy reversible? J Clin Gastroenterol. 2009;43(2):176–81.
Tarter RE, Switala JA, Arria A, Plail J, Van Thiel DH. Subclinical hepatic encephalopathy. Comparison before and after orthotopic liver transplantation. Transplantation. 1990;50(4):632–7.
Mechtcheriakov S, Graziadei IW, Mattedi M, Bodner T, Kugener A, Hinterhuber HH, et al. Incomplete improvement of visuo-motor deficits in patients with minimal hepatic encephalopathy after liver transplantation. Liver Transpl. 2004;10(1):77–83.
Mattarozzi K, Stracciari A, Vignatelli L, D’Alessandro R, Morelli MC, Guarino M. Minimal hepatic encephalopathy: longitudinal effects of liver transplantation. Arch Neurol. 2004;61(2):242–7.
Thomas MA, Huda A, Guze B, Curran J, Bugbee M, Fairbanks L, et al. Cerebral 1H MR spectroscopy and neuropsychologic status of patients with hepatic encephalopathy. AJR Am J Roentgenol. 1998;171(4):1123–30.
Rovira A, Minguez B, Aymerich FX, Jacas C, Huerga E, Cordoba J, et al. Decreased white matter lesion volume and improved cognitive function after liver transplantation. Hepatology. 2007;46(5):1485–90.
Pujol J, Kulisevsky J, Moreno A, Deus J, Alonso J, Balanzo J, et al. Neurospectroscopic alterations and globus pallidus hyperintensity as related magnetic resonance markers of reversible hepatic encephalopathy. Neurology. 1996;47(6):1526–30.
Chavarria L, Alonso J, Garcia-Martinez R, Aymerich FX, Huerga E, Jacas C, et al. Biexponential analysis of diffusion-tensor imaging of the brain in patients with cirrhosis before and after liver transplantation. AJNR Am J Neuroradiol. 2011;32(8):1510–7.
Senzolo M, Pizzolato G, Ferronato C, Chierichetti F, Boccagni P, Dam M, et al. Long-term evaluation of cognitive function and cerebral metabolism in liver transplanted patients. Transplant Proc. 2009;41(4):1295–6.
Ciancio A, Marchet A, Saracco G, Carucci P, Lavezzo B, Leotta D, et al. Spectral electroencephalogram analysis in hepatic encephalopathy and liver transplantation. Liver Transpl. 2002;8(7):630–5.
Kril JJ, Butterworth RF. Diencephalic and cerebellar pathology in alcoholic and nonalcoholic patients with end-stage liver disease. Hepatology. 1997;26(4):837–41.
Stracciari A, Guarino M. Neuropsychiatric complications of liver transplantation. Metab Brain Dis. 2001;16(1–2):3–11.
Herrero JI, Bilbao JI, Diaz ML, Alegre F, Inarrairaegui M, Pardo F, et al. Hepatic encephalopathy after liver transplantation in a patient with a normally functioning graft: treatment with embolization of portosystemic collaterals. Liver Transpl. 2009;15(1):111–4.
Sotil EU, Gottstein J, Ayala E, Randolph C, Blei AT. Impact of preoperative overt hepatic encephalopathy on neurocognitive function after liver transplantation. Liver Transpl. 2009;15(2):184–92.
Bajaj JS, Schubert CM, Heuman DM, Wade JB, Gibson DP, Topaz A, et al. Persistence of cognitive impairment after resolution of overt hepatic encephalopathy. Gastroenterology. 2010;138(7):2332–40.
Bajaj JS, Saeian K. MELD score does not discriminate against patients with hepatic encephalopathy. Dig Dis Sci. 2005;50(4):753–6.
Balderramo D, Prieto J, Cardenas A, Navasa M. Hepatic encephalopathy and post-transplant hyponatremia predict early calcineurin inhibitor-induced neurotoxicity after liver transplantation. Transpl Int. 2011;24(8):812–9.
Ham J, Gish RG, Mullen K. Model for end-stage liver disease (MELD) exception for hepatic encephalopathy. Liver Transpl. 2006;12(12 Suppl 3):S102–4.
Freeman Jr RB, Gish RG, Harper A, Davis GL, Vierling J, Lieblein L, et al. Model for end-stage liver disease (MELD) exception guidelines: results and recommendations from the MELD Exception Study Group and Conference (MESSAGE) for the approval of patients who need liver transplantation with diseases not considered by the standard MELD formula. Liver Transpl. 2006;12(12 Suppl 3):S128–36.
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Atluri, D.K., Mullen, K.D. (2012). Liver Transplantation and Hepatic Encephalopathy. In: Mullen, K., Prakash, R. (eds) Hepatic Encephalopathy. Clinical Gastroenterology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-836-8_19
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