Ruck Jessica M, Murriel Emily C, Fortune Hernandez Nicole, Jefferis Alexa A, McAdams DeMarco Mara, Vannorsdall Tracy D, Segev Dorry L, King Elizabeth A, Oh Esther S
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Liver Transpl. 2025 Aug 1;31(8):1020-1030. doi: 10.1097/LVT.0000000000000569. Epub 2025 Jan 17.
Impaired cognition in liver recipients has been studied in the immediate posttransplant period but is poorly understood in the long term, despite its importance to quality of life. In a single-center cohort of liver recipients transplanted in 2010-2022 and >1 year after transplant, we assessed cognitive performance using a telephone-based battery. We compared depression, anxiety, and self-reported function by cognitive performance using descriptive statistics. Among 120 participants (median age 65, median 7.3 y after transplant), 25% had below-expectation cognition, 53% at-expectation cognition, and 22% above-expectation. Baseline characteristics were similar between groups. Below-expectation performance was most commonly observed in verbal learning (28%) and verbal memory (22%). Overall, 46% had symptoms of depression (38%) and/or anxiety (28%); anxiety was less common among those with above-expectation cognition (0%) versus below-expectation (34%) or at-expectation cognition (38%, p=0.01). The impaired global daily function was reported by 36% of recipients but was not associated with objective cognitive performance. Below-expectation cognition was prevalent among 25% of liver recipients at least 1 year after transplant and was associated with a higher likelihood of reporting psychiatric distress. These findings underscore the need for longitudinal assessment of cognitive and mental health outcomes among recipients of liver transplants.
肝移植受者的认知功能障碍在移植后的即刻阶段已得到研究，但尽管其对生活质量很重要，长期以来人们对它的了解却很少。在一个单中心队列中，我们对2010年至2022年接受移植且移植后超过1年的肝移植受者，使用一套基于电话的测试组合来评估其认知表现。我们使用描述性统计方法，根据认知表现比较了抑郁、焦虑和自我报告的功能。在120名参与者（中位年龄65岁，移植后中位时间7.3年）中，25%的人认知低于预期，53%的人认知符合预期，22%的人认知高于预期。各组之间的基线特征相似。在言语学习（28%）和言语记忆（22%）方面，最常观察到低于预期的表现。总体而言，46%的人有抑郁（38%）和/或焦虑（28%）症状；认知高于预期的人（0%）中焦虑较少见，而认知低于预期的人（34%）和认知符合预期的人（38%）中焦虑较常见（p=0.01）。36%的受者报告日常整体功能受损，但这与客观认知表现无关。移植后至少1年的肝移植受者中，25%存在低于预期的认知，且报告精神困扰的可能性更高。这些发现强调了对肝移植受者的认知和心理健康结果进行纵向评估的必要性。
