Cerebral metabolite alterations in patients with posttransplant encephalopathy after liver transplantation

Autor: Annemarie Goldbecker, Hannelore Barg-Hock, Anita B. Tryc, Henning Pflugrad, Karin Weissenborn, Christian P. Strassburg, Peter Raab, Heinrich Lanfermann, Jürgen Klempnauer
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Central Nervous System
Cirrhosis
Magnetic Resonance Spectroscopy
medicine.medical_treatment
Liver transplantation
Chronic liver disease
Gastroenterology
Biochemistry
Nervous System
Diagnostic Radiology
chemistry.chemical_compound
0302 clinical medicine
Thalamus
Medicine and Health Sciences
Metabolites
Choline
Brain Mapping
Multidisciplinary
Radiology and Imaging
Liver Diseases
Brain
Middle Aged
Magnetic Resonance Imaging
Thalamic Nuclei
Metabolome
Medicine
030211 gastroenterology & hepatology
Female
Anatomy
Research Article
medicine.medical_specialty
Lentiform nucleus
Imaging Techniques
Science
Encephalopathy
Surgical and Invasive Medical Procedures
Gastroenterology and Hepatology
Creatine
Research and Analysis Methods
Phosphocreatine
03 medical and health sciences
Digestive System Procedures
Diagnostic Medicine
Internal medicine
medicine
Humans
Transplantation
business.industry
Biology and Life Sciences
Organ Transplantation
medicine.disease
Liver Transplantation
Metabolism
chemistry
Case-Control Studies
Hepatic Encephalopathy
business
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE, Vol 14, Iss 8, p e0221626 (2019)
PLoS ONE
ISSN: 1932-6203
Popis: BackgroundIn the first weeks after liver transplantation about 30% of the patients develop a posttransplant encephalopathy. A posttransplant encephalopathy comprises metabolic-toxic caused symptoms such as disorientation, confusion, hallucinations, cognitive dysfunction and seizures. We hypothesize that alterations of cerebral metabolites before liver transplantation predispose posttransplant encephalopathy development after liver transplantation.Methods31 patients with chronic liver disease underwent magnetic resonance spectroscopy (MRS) before liver transplantation to assess glutamine/glutamate (Glx), myo-Inositol (mI), choline (Cho), creatine/phosphocreatine- and N-acetyl-aspartate/N-acetyl-aspartate-glutamate concentrations in the thalamus, lentiform nucleus and white matter. Of these, 14 patients underwent MRS additionally after liver transplantation. Furthermore, 15 patients received MRS only after liver transplantation. Patients' data were compared to 20 healthy age adjusted controls.ResultsPatients showed significantly increased Glx and decreased mI and Cho concentrations compared to controls before liver transplantation (p≤0.01). The MRS values before liver transplantation of patients with posttransplant encephalopathy showed no significant difference compared to patients without posttransplant encephalopathy. Patients after liver transplantation showed increased Glx concentrations (p≤0.01) compared to controls, however, patients with and without posttransplant encephalopathy did not differ. Patients with posttransplant encephalopathy who underwent MRS before and after liver transplantation showed a significant mI increase in all three brain regions (pConclusionPatients with and without posttransplant encephalopathy showed no significant difference in cerebral metabolites before liver transplantation. However, the paired sub-analysis indicates that the extent of cerebral metabolite alterations in patients with liver cirrhosis might be critical for the development of posttransplant encephalopathy after liver transplantation.
Databáze: OpenAIRE
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