Cerebrovascular events in 20 years of follow-up after liver transplantation: an underestimated issue?

Autor:	Andreas Pascher, Marcus Bahra, Niklas Buescher, Andreas Andreou, Nadja Neidel, Wenzel Schoening, Johann Pratschke, Michael Helbig, Daniel Seehofer
Rok vydání:	2016
Předmět:	Adult Male medicine.medical_specialty Long term follow up medicine.medical_treatment Renal function 030230 surgery Liver transplantation Risk Assessment Decision Support Techniques 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine Health Status Indicators Humans Medicine Patient group Stroke Aged Retrospective Studies Transplantation business.industry Incidence Incidence (epidemiology) Retrospective cohort study Middle Aged Prognosis medicine.disease Liver Transplantation Surgery Cerebrovascular Disorders Increased risk Female business 030217 neurology & neurosurgery Follow-Up Studies
Zdroj:	Clinical Transplantation. 30:1276-1282
ISSN:	0902-0063
Popis:	BACKGROUND Cardio- and cerebrovascular diseases are the third leading cause of late death after liver transplantation (LT). A new score (PROCAM-Stroke) has been established to estimate the 10-year risk of cerebrovascular events (CBVE) in a German standard population. We evaluate the applicability of the PROCAM-Stroke for long-term follow-up after LT. PATIENTS AND METHODS A retrospective study of 313 consecutive LTs was conducted. Six months after LT (T1) and 10 years after LT (T2), CBVE risk factors were recorded and PROCAM-Stroke was calculated. Ten (T2) and 20 years (T3) after LT, recipients were screened regarding CBVE. PROCAM-Stroke estimates of CBVE were compared with the incidence of observed CBVE. RESULTS In both 10-year time frames, the incidence of observed CBVE was higher than expected based on the PROCAM-Stroke estimates: 6 months-10 years after LT (T1-T2): observed: 11, expected: 3.2; 10 years-20 years after LT (T2-T3): observed: 7, expected: 3.4. CONCLUSION LT recipients seem to have a considerably increased risk of CBVE. Long-term surveillance should take this into account, and screening may be extended accordingly. The progressive impairment of renal function in the long-term LT survivors may be one reason for the underestimation of CBVE in this patient group.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::049b004cc2716ee255bf958a7a4af7b3 https://doi.org/10.1111/ctr.12819 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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