466 NATREMIA AND CHILD-TURCOTTE-PUGH (CTP) SCORE MAY IMPROVE THE SELECTION OF CANDIDATES FOR LIVER TRANSPLANTATION (LT) WITH LOW MODEL FOR END-STAGE LIVER DISEASE SCORE (MELD)
2009; Elsevier BV; Volume: 50; Linguagem: Inglês
10.1016/s0168-8278(09)60468-2
ISSN1600-0641
AutoresStefano Gitto, Maurizio Biselli, Annagiulia Gramenzi, Giovanni Vitale, Stefania Lorenzini, Roberto Di Donato, Lucia Brodosi, Maria Cristina Morelli, Gian Luca Grazi, Antonio Daniele Pinna, Mauro Bernardi, Pietro Andreoné, Bologna Liver Transplantation Group,
Tópico(s)Organ Transplantation Techniques and Outcomes
ResumoS175Pegboard), executive function (Hooper) and memory (Auditory Verbal Learning). Results:1. Short-term post-LTx: The VV (cm3) increased by 8%.Fourteen patients exhibited FWML that decreased the volume by 20%, which can be explained by reversible brain edema in this areas.Neuropsychological tests improved indicating reversal of minimal hepatic encephalopathy.2. Long-term post-LTx: The VV increased by 60% and the volume of FWML increased by 25%.Neuropsychological tests remained stable, except for memory that showed deterioration.Changes in VV or FWML were not associated with prior HE.Among patients with larger changes in FWML (>15%) pharmacological treatment for arterial hypertension was more common (88% vs. 33%, p = 0.05) and creatinine tended to be higher (1.37±0.21 vs. 1.19±0.15mg/dl, p = 0.06).Conclusion: Following LTx patients develop a decrease in brain volume despite a successful outcome of liver function.The initial decrease probably reflects disappearance of brain edema related to HE.The decrease at long-term is part of a degenerative process in part caused by small-vessel cerebrovascular disease.Adequate control of vascular risk factors appears critical to prevent neurological deterioration following LTx.
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