ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2016
Liver transplantation significantly improves global functioning and cerebral processing.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Cognitive Impairment After Resolution of Hepatic Encephalopathy: A Systematic Review and Meta-Analysis.Frontiers in neuroscience · 2021Pooled it
- The Influence of Social and Psychological Factors on Cognition Among Liver Transplant Recipients.Progress in transplantation (Aliso Viejo, Calif.) · 2026Article
- Hepatic encephalopathy as an indication or contraindication to liver transplant?Metabolic brain disease · 2025Review
- Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review.Transplantation direct · 2023Article
- Regulation of mild cognitive impairment associated with liver disease by humoral factors derived from the gastrointestinal tract and MRI research progress: a literature review.Frontiers in neuroscience · 2023Review
- Subjective Cognition is Related to Patient-Reported Symptom Distress and Work Productivity Among Liver Transplant Recipients.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- A Brief History of Hepatic Encephalopathy.Clinical liver disease · 2021Review
- Cognitive Function in Liver Transplantation.Current transplantation reports · 2020Review
- Cerebral metabolite alterations in patients with posttransplant encephalopathy after liver transplantation.PloS one · 2019Article
- Multimodal MR imaging in hepatic encephalopathy: state of the art.Metabolic brain disease · 2018Review
- Oral health-related quality of life depending on dental and periodontal health in different patients before and after liver transplantation.Clinical oral investigations · 2018Article
- Brain Integrity Changes Underlying Cognitive and Functional Recovery Postliver Transplant Continue to Evolve Over 1 Year.Transplantation · 2018Article
- Overt hepatic encephalopathy impairs learning on the EncephalApp stroop which is reversible after liver transplantation.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2017Article
- Mindfulness-Based Stress Reduction Therapy Improves Patient and Caregiver-Reported Outcomes in Cirrhosis.Clinical and translational gastroenterology · 2017Article
- Symptom Domain Groups of the Patient-Reported Outcomes Measurement Information System Tools Independently Predict Hospitalizations and Re-hospitalizations in Cirrhosis.Digestive diseases and sciences · 2017Article
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Authors and funding
21 authors at 1 institution in 1 country.
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Abstract
The functional basis of cognitive and quality of life changes after liver transplant is unclear. We aimed to evaluate the neurometabolic and functional brain changes as modulators of cognition and quality of life after transplant in patients with cirrhosis who were with/without pretransplant cognitive impairment and hepatic encephalopathy (HE). Patients with cirrhosis underwent detailed cognitive and quality of life assessment at enrollment and 6 months after transplant. A subset underwent brain magnetic resonance imaging (functional magnetic resonance imaging [fMRI], diffusion tensor imaging [DTI], and magnetic resonance spectroscopy [MRS]) before and after transplant. Changes before and after transplant were analyzed in all patients and by dividing groups in those with/without pretransplant cognitive impairment or with/without pretransplant HE. MRS evaluated ammonia-related metabolites; fMRI studied brain activation for correct lure inhibition on the inhibitory control test; and DTI studied white matter integrity. Sixty-six patients (mean Model for End-Stage Liver Disease score, 21.8; 38 HE patients and 24 cognitively impaired [CI] patients) were enrolled. Quality of life was significantly worse in CI and HE groups before transplant, which improved to a lesser extent in those with prior cognitive impairment. In the entire group after transplant, there was (1) significantly lower brain activation needed for lure inhibition (shown on fMRI); (2) reversal of pretransplant ammonia-associated changes (shown on MRS); and (3) improved white matter integrity (shown on DTI). Importantly, study findings suggest that pretransplant cognitive impairment serves as a marker for clinical outcomes. Regardless of pretransplant history of HE, it was the pretransplant cognitive impairment that was predictive of both posttransplant cognitive and psychosocial outcomes. Therefore, when working with patients and their families, a clinician may rely on the pretransplant cognitive profile to develop expectations regarding posttransplant neurobehavioral recovery. We conclude that functional brain changes after liver transplant depend on pretransplant cognitive impairment and are ultimately linked with posttransplant cognition and quality of life in cirrhosis. Liver Transplantation 22 1379-1390 2016 AASLD.
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