Lacerda S S, Guimaro M S, Prade C V, Ferraz-Neto B H, Karam C H, Andreoli P B A
Psychology Service and the Transplantation Unit of the Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Transplant Proc. 2008 Apr;40(3):729-31. doi: 10.1016/j.transproceed.2008.02.042.
Chronic renal and liver diseases are associated with cognitive and intellectual impairment, which can be irreversible even after kidney or liver transplantation.
We sought to investigate the presence of cognitive deficits in organ transplantation candidates.
From May 2005 to March 2006, 35 organ transplantation candidates, of mean age 46.71 (+/- 13.01) years, 54.3% including females and 7.29 (+/- 4.22) years mean formal schooling. Of those, 27 (77%) were renal and 8 (23%), liver transplantation candidates. All subjects underwent a neuropsychological assessment battery designed to evaluate attention performance, executive functions, memory, language, visuaospatial, and intellectual skills.
We found impairments in attention performance (attention span [34.3%], sustained attention [76.5%], and divided attention [77.8%]), executive functions (category formation [58.3%], errors [61.5%], and perseverative errors [30.4%]), memory (working memory [57.1%], verbal [37.1%] and visual short-term memory [31.4%], verbal [25.7%] and visual long-term memory [51.4], verbal learning [42.9%], interference susceptibility [42.9%], and verbal recognition memory [20.6%]), language (comprehension [38.1%], and vocabulary [30.8%]), visuaospatial (45.8%), and intellectual skills (50.0%).
Neuropsychological (cognitive) deficits in transplant candidates are frequent, regardless of the kind of transplantation. The deficits involve several cognitive skills, such as attentional processes, executive functions, memory, language, visuaospatial, and intellectual skills. Therefore, we concluded that a pretransplant neuropsychological assessment is an important measure to detect impairments and to help understand how these difficulties can interfere with patient self-care before and after transplantation.
慢性肾脏和肝脏疾病与认知及智力损害相关，即便在肾移植或肝移植后这种损害也可能不可逆转。
我们试图调查器官移植候选者中认知缺陷的存在情况。
2005年5月至2006年3月，35名器官移植候选者，平均年龄46.71（±13.01）岁，54.3%为女性，平均正规教育年限7.29（±4.22）年。其中，27名（77%）为肾移植候选者，8名（23%）为肝移植候选者。所有受试者均接受了一套神经心理学评估，旨在评估注意力表现、执行功能、记忆、语言、视觉空间和智力技能。
我们发现注意力表现存在损害（注意力广度[34.3%]、持续性注意力[76.5%]和分散注意力[77.8%]）、执行功能（类别形成[58.3%]、错误[61.5%]和持续性错误[30.4%]）、记忆（工作记忆[57.1%]、言语[37.1%]和视觉短期记忆[31.4%]、言语[25.7%]和视觉长期记忆[51.4%]、言语学习[42.9%]、干扰易感性[42.9%]和言语识别记忆[20.6%]）、语言（理解[38.1%]和词汇[30.8%]）、视觉空间（45.8%）和智力技能（50.0%）方面的损害。
移植候选者中神经心理学（认知）缺陷很常见，与移植类型无关。这些缺陷涉及多种认知技能，如注意力过程、执行功能、记忆、语言、视觉空间和智力技能。因此，我们得出结论，移植前神经心理学评估是检测损害以及帮助了解这些困难如何在移植前后干扰患者自我护理的一项重要措施。
