Albhaisi Somaya A M, Bajaj Jasmohan S
1Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23298-0341 USA.
2Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA USA.
Curr Transplant Rep. 2020;7(2):31-37. doi: 10.1007/s40472-020-00274-2. Epub 2020 Mar 26.
Liver transplantation (LT) remains the only way to cure patients with severe liver diseases. Important questions about neurological sequelae and quality of life after LT have emerged. In this review, we discuss the neurocognitive changes associated with LT and we conclude with recommendations in this regard for patients, caregivers, and physicians.
Compared with other solid organ recipients, LT patients tend to have a higher incidence (up to 30%) of neurological complications post-LT. Even in absence of previous episodes of hepatic encephalopathy (HE), some patients display new onset of neurological symptoms post-LT, raising the concern about the role of other factors that may have a direct impact on cognitive function.
Different mechanisms have been postulated to explain these postoperative neurological symptoms. They include sequelae of HE, persistent impairment of cognitive function due to cirrhosis, or postoperative decompensation of an unknown or undiagnosed neurodegenerative disorder.
肝移植(LT)仍然是治疗重症肝病患者的唯一方法。关于肝移植后神经后遗症和生活质量的重要问题已经出现。在本综述中,我们讨论了与肝移植相关的神经认知变化,并在此为患者、护理人员和医生给出相关建议。
与其他实体器官移植受者相比,肝移植患者肝移植后神经并发症的发生率往往更高(高达30%)。即使在既往没有肝性脑病(HE)发作的情况下,一些患者在肝移植后仍会出现新的神经症状,这引发了人们对可能直接影响认知功能的其他因素作用的关注。
已经提出了不同的机制来解释这些术后神经症状。它们包括肝性脑病的后遗症、肝硬化导致的认知功能持续损害,或未知或未诊断的神经退行性疾病的术后失代偿。