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肝移植术后神经系统及神经认知相关并发症的研究进展

苗晓蕾 吴延 吴安石

苗晓蕾, 吴延, 吴安石. 肝移植术后神经系统及神经认知相关并发症的研究进展[J]. 器官移植, 2020, 11(3): 424-430. doi: 10.3969/j.issn.1674-7445.2020.03.018
引用本文: 苗晓蕾, 吴延, 吴安石. 肝移植术后神经系统及神经认知相关并发症的研究进展[J]. 器官移植, 2020, 11(3): 424-430. doi: 10.3969/j.issn.1674-7445.2020.03.018
Miao Xiaolei, Wu Yan, Wu Anshi. Research progress of nervous system and neurocognition-related complications after liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 424-430. doi: 10.3969/j.issn.1674-7445.2020.03.018
Citation: Miao Xiaolei, Wu Yan, Wu Anshi. Research progress of nervous system and neurocognition-related complications after liver transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 424-430. doi: 10.3969/j.issn.1674-7445.2020.03.018

肝移植术后神经系统及神经认知相关并发症的研究进展

doi: 10.3969/j.issn.1674-7445.2020.03.018
基金项目: 

北京市医管局“扬帆计划” ZYLX201822

详细信息
    作者简介:

    苗晓蕾,女,1987年生,博士,主治医师,研究方向为围手术期脑保护,Email:xiaoleimiaoabs@163.com

    通讯作者:

    吴延,男,1969年生,博士,主任医师,研究方向为心胸与器官移植手术麻醉学,E-mail:wuyan@bjcyh.com

    吴安石,男,1965年生,博士,博士研究生导师,主任医师,研究方向为器官移植和心胸外科麻醉与器官保护,E-mail:wuanshi88@163.com

  • 中图分类号: R617, R395.5

Research progress of nervous system and neurocognition-related complications after liver transplantation

More Information
  • 摘要: 随着肝移植术后生存率的逐渐提高,术后神经系统及神经认知相关并发症成为研究关注的重要问题。相对于其他实体器官移植,肝移植术后神经系统并发症的发生率更高,且与患者的死亡密切相关。本文主要针对肝移植术后神经系统并发症、神经认知相关并发症以及引起这些并发症的危险因素进行综述,还探讨了如何评估、监测和预防这些并发症,以期为未来研究提供参考。

     

  • [1] FELTRACCO P, CAGNIN A, CAROLLO C, et al. Neurological disorders in liver transplant candidates: pathophysiology and clinical assessment[J]. Transplant Rev (Orlando), 2017, 31(3): 193-206. DOI: 10.1016/j.trre.2017.02.006.
    [2] CHUNG MS, KIM HS, LIM YS, et al. Clinical impact of preoperative brain MR angiography and MR imaging in candidates for liver transplantation: a propensity score-matching study in a single institution[J]. Eur Radiol, 2017, 27(8): 3532-3541. DOI: 10.1007/s00330-017-4741-z.
    [3] MAGGI DC, BORGONOVO A, BANSHO ET, et al. Serial assessment of hepatic encephalopathy in patients hospitalised for acute decompensation of cirrhosis[J]. Ann Hepatol, 2019, 18(2): 331-337. DOI: 10.1016/j.aohep.2018.11.002.
    [4] ROMERO- GÓMEZ M, MONTAGNESE S, JALAN R. Hepatic encephalopathy in patients with acute decompensation of cirrhosis and acute-on-chronic liver failure[J]. J Hepatol, 2015, 62(2): 437-447. DOI: 10.1016/j.jhep.2014.09.005.
    [5] BJERRING PN, BJERRUM EJ, LARSEN FS. Impaired cerebral microcirculation induced by ammonium chloride in rats is due to cortical adenosine release[J]. J Hepatol, 2018, 68(6): 1137-1143. DOI: 10.1016/j.jhep.2018.01.034.
    [6] DERLE E, KIBAROǦL US, ÖCAL R, et al. Seizure as a neurologic complication after liver transplant[J]. Exp Clin Transplant, 2015, 13 (Suppl 1): 323-326. DOI: 10.6002/ect.mesot2014.p176.
    [7] CHOI EJ, KANG JK, LEE SA, et al. New-onset seizures after liver transplantation: clinical implications and prognosis in survivors[J]. Eur Neurol, 2004, 52(4): 230-236. DOI: 10.1159/000082163.
    [8] AMODIO P, BIANCARDI A, MONTAGNESE S, et al. Neurological complications after orthotopic liver transplantation[J]. Dig Liver Dis, 2007, 39(8): 740-747. DOI: 10.1016/j.dld.2007.05.004.
    [9] WSZOLEK ZK, STEG RE. Seizures after orthotopic liver transplantation[J]. Seizure, 1997, 6(1): 31-39. DOI: 10.1016/s1059-1311(97)80050-7.
    [10] LECKER I, WANG DS, KANESHWARAN K, et al. High concentrations of tranexamic acid inhibit ionotropic glutamate receptors[J]. Anesthesiology, 2017, 127(1): 89-97. DOI: 10.1097/ALN.0000000000001665.
    [11] CRISMALE JF, MELIAMBRO KA, DEMARIA S JR, et al. Prevention of the osmotic demyelination syndrome after liver transplantation: a multidisciplinary perspective[J]. Am J Transplant, 2017, 17(10): 2537-2545. DOI: 10.1111/ajt.14317.
    [12] SINGH TD, FUGATE JE, RABINSTEIN AA. Central pontine and extrapontine myelinolysis: a systematic review[J]. Eur J Neurol, 2014, 21(12): 1443-1450. DOI: 10.1111/ene.12571.
    [13] MORARD I, GASCHE Y, KNETEMAN M, et al. Identifying risk factors for central pontine and extrapontine myelinolysis after liver transplantation: a case-control study[J]. Neurocrit Care, 2014, 20(2): 287-295. DOI: 10.1007/s12028-013-9928-9.
    [14] HOORN EJ, ZIETSE R. Diagnosis and treatment of hyponatremia: compilation of the guidelines[J]. J Am Soc Nephrol, 2017, 28(5): 1340-1349. DOI: 10.1681/ASN.2016101139.
    [15] SHARMA P, SCHAUBEL DE, GOODRICH NP, et al. Serum sodium and survival benefit of liver transplantation[J]. Liver Transpl, 2015, 21(3): 308-313. DOI: 10.1002/lt.24063.
    [16] DONNELLY H, CONNOR S, QUIRK J. Central pontine myelinolysis secondary to hyperglycaemia[J]. Pract Neurol, 2016, 16(6): 493-495. DOI: 10.1136/practneurol-2016-001389.
    [17] LOUIS G, MEGARBANE B, LAVOUÉ S, et al. Long-term outcome of patients hospitalized in intensive care units with central or extrapontine myelinolysis*[J]. Crit Care Med, 2012, 40(3): 970-972. DOI: 10.1097/CCM.0b013e318236f152.
    [18] FUGATE JE, RABINSTEIN AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions[J]. Lancet Neurol, 2015, 14(9): 914-925. DOI: 10.1016/S1474-4422(15)00111-8.
    [19] BERNHARDT M, PFLUGRAD H, GOLDBECKER A, et al. Central nervous system complications after liver transplantation: common but mostly transient phenomena[J]. Liver Transpl, 2015, 21(2): 224-232. DOI: 10.1002/lt.24035.
    [20] CRUZ RJ JR, DIMARTINI A, AKHAVANHEIDARI M, et al. Posterior reversible encephalopathy syndrome in liver transplant patients: clinical presentation, risk factors and initial management[J]. Am J Transplant, 2012, 12(8): 2228-2236. DOI: 10.1111/j.1600-6143.2012.04048.x.
    [21] BARTYNSKI WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features[J]. AJNR Am J Neuroradiol, 2008, 29(6): 1036-1042. DOI: 10.3174/ajnr.A0928.
    [22] BARTYNSKI WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema[J]. AJNR Am J Neuroradiol, 2008, 29(6): 1043-1049. DOI: 10.3174/ajnr.A0929.
    [23] OLLIVIER M, BERTRAND A, CLARENÇON F, et al. Neuroimaging features in posterior reversible encephalopathy syndrome: a pictorial review[J]. J Neurol Sci, 2017, 373: 188-200. DOI: 10.1016/j.jns.2016.12.007.
    [24] PEDERSEN M, SEETHARAM A. Infections after orthotopic liver transplantation[J]. J Clin Exp Hepatol, 2014, 4(4): 347-360. DOI: 10.1016/j.jceh.2014.07.004.
    [25] PHAN TL, LAUTENSCHLAGER I, RAZONABLE RR, et al. HHV-6 in liver transplantation: a literature review[J]. Liver Int, 2018, 38(2): 210-223. DOI: 10.1111/liv.13506.
    [26] CHARLIER C, PERRODEAU É, LECLERCQ A, et al. Clinical features and prognostic factors of listeriosis: the MONALISA national prospective cohort study[J]. Lancet Infect Dis, 2017, 17(5): 510-519. DOI: 10.1016/S1473-3099(16)30521-7.
    [27] DALTON HR, VAN EIJK JJJ, CINTAS P, et al. Hepatitis E virus infection and acute non-traumatic neurological injury: a prospective multicentre study[J]. J Hepatol, 2017, 67(5): 925-932. DOI: 10.1016/j.jhep.2017.07.010.
    [28] JOLLEY SE, BUNNELL AE, HOUGH CL. ICU-acquired weakness[J]. Chest, 2016, 150(5): 1129-1140. DOI: 10.1016/j.chest.2016.03.045.
    [29] GREENHILL C. Liver transplantation: long-term cognitive function improved in MHE after liver transplantation[J]. Nat Rev Gastroenterol Hepatol, 2012, 9(3): 126. DOI: 10.1038/nrgastro.2012.17.
    [30] CAMPAGNA F, MONTAGNESE S, SCHIFF S, et al. Cognitive impairment and electroencephalographic alterations before and after liver transplantation: what is reversible? [J]. Liver Transpl, 2014, 20(8): 977-986. DOI: 10.1002/lt.23909.
    [31] FINEBERG SK, WEST A, NA PJ, et al. Utility of pretransplant psychological measures to predict posttransplant outcomes in liver transplant patients: a systematic review[J]. Gen Hosp Psychiatry, 2016, 40: 4-11. DOI: 10.1016/j.genhosppsych.2016.01.006.
    [32] ACETO P, PERILLI V, LAI C, et al. Postoperative cognitive dysfunction after liver transplantation[J]. Gen Hosp Psychiatry, 2015, 37(2): 109-115. DOI: 10.1016/j.genhosppsych.2014.12.001.
    [33] PFLUGRAD H, TRYC AB, GOLDBECKER A, et al. Hepatic encephalopathy before and neurological complications after liver transplantation have no impact on the employment status 1 year after transplantation[J]. World J Hepatol, 2017, 9(10): 519-532. DOI: 10.4254/wjh.v9.i10.519.
    [34] PEGUM N, CONNOR JP, FEENEY GF, et al. Neuropsychological functioning in patients with alcohol-related liver disease before and after liver transplantation[J]. Transplantation, 2011, 92(12): 1371-1377. DOI: 10.1097/TP.0b013e3182375881.
    [35] SENZOLO M, PIZZOLATO G, FERRONATO C, et al. Long-term evaluation of cognitive function and cerebral metabolism in liver transplanted patients[J]. Transplant Proc, 2009, 41(4): 1295-1296. DOI: 10.1016/j.transproceed.2009.03.087.
    [36] CHAVARRIA L, ALONSO J, GARCÍA-MARTÍNEZ R, et al. Biexponential analysis of diffusion-tensor imaging of the brain in patients with cirrhosis before and after liver transplantation[J]. AJNR Am J Neuroradiol, 2011, 32(8): 1510-1517. DOI: 10.3174/ajnr.A2533.
    [37] ISHIHARA T, ITO M, NIIMI Y, et al. Clinical and radiological impact of liver transplantation for brain in cirrhosis patients without hepatic encephalopathy[J]. Clin Neurol Neurosurg, 2013, 115(11): 2341-2347. DOI: 10.1016/j.clineuro.2013.08.015.
    [38] LIN WC, CHOU KH, CHEN CL, et al. Longitudinal brain white matter alterations in minimal hepatic encephalopathy before and after liver transplantation[J]. PLoS One, 2014, 9(8): e105887. DOI: 10.1371/journal.pone.0105887.
    [39] CHENG Y, HUANG L, ZHANG X, et al. Liver transplantation nearly normalizes brain spontaneous activity and cognitive function at 1 month: a resting-state functional MRI study[J]. Metab Brain Dis, 2015, 30(4): 979-988. DOI: 10.1007/s11011-015-9657-1.
    [40] ZHANG XD, CHENG Y, POON CS, et al. Long-and short-range functional connectivity density alteration in non-alcoholic cirrhotic patients one month after liver transplantation: a resting-state fMRI study[J]. Brain Res, 2015, 1620: 177-187. DOI: 10.1016/j.brainres.2015.04.046.
    [41] CHENG Y, HUANG LX, ZHANG L, et al. Longitudinal intrinsic brain activity changes in cirrhotic patients before and one month after liver transplantation[J]. Korean J Radiol, 2017, 18(2): 370-377. DOI: 10.3348/kjr.2017.18.2.370.
    [42] CHENG Y, ZHANG G, SHEN W, et al. Impact of previous episodes of hepatic encephalopathy on short-term brain function recovery after liver transplantation: a functional connectivity strength study[J]. Metab Brain Dis, 2018, 33(1): 237-249. DOI: 10.1007/s11011-017-0155-5.
    [43] FU KA, DINORCIA J, SHER L, et al. Predictive factors of neurological complications and one-month mortality after liver transplantation[J]. Front Neurol, 2014, 5: 275. DOI: 10.3389/fneur.2014.00275.
    [44] WU SY, CHEN TW, FENG AC, et al. Comprehensive risk assessment for early neurologic complications after liver transplantation[J]. World J Gastroenterol, 2016, 22(24): 5548-5557. DOI: 10.3748/wjg.v22.i24.5548.
    [45] WEISS N, JALAN R, THABUT D. Understanding hepatic encephalopathy[J]. Intensive Care Med, 2018, 44(2): 231-234. DOI: 10.1007/s00134-017-4845-6.
    [46] YOU DD, CHOI GS, KIM JM, et al. Long-term outcomes for liver transplant recipients in terms of hepatic encephalopathy[J]. Transplant Proc, 2017, 49(6): 1425-1429. DOI: 10.1016/j.transproceed.2017.02.054.
    [47] ALLAMPATI S, MULLEN KD. Does overt hepatic encephalopathy cause persistent cognitive defects even after successful liver transplantation? [J]. Liver Transpl, 2014, 20(8): 874-875. DOI: 10.1002/lt.23938.
    [48] WEISS N, MOCHEL F, RUDLER M, et al. Peak hyperammonemia and atypical acute liver failure: the eruption of an urea cycle disorder during hyperemesis gravidarum[J]. J Hepatol, 2018, 68(1): 185-192. DOI: 10.1016/j.jhep.2017.09.009.
    [49] WEINSTEIN G, ZELBER-SAGI S, PREIS SR, et al. Association of nonalcoholic fatty liver disease with lower brain volume in healthy middle-aged adults in the framingham study[J]. JAMA Neurol, 2018, 75(1): 97-104. DOI: 10.1001/jamaneurol.2017.3229.
    [50] AHLUWALIA V, WADE JB, MOELLER FG, et al. The etiology of cirrhosis is a strong determinant of brain reserve: a multimodal magnetic resonance imaging study[J]. Liver Transpl, 2015, 21(9): 1123-1132. DOI: 10.1002/lt.24163.
    [51] WU WY, KANG KH, CHEN SL, et al. Hepatitis C virus infection: a risk factor for Parkinson's disease[J]. J Viral Hepat, 2015, 22(10): 784-791. DOI: 10.1111/jvh.12392.
    [52] SAKUSIC A, O'HORO JC, DZIADZKO M, et al. Potentially modifiable risk factors for long-term cognitive impairment after critical illness: a systematic review[J]. Mayo Clin Proc, 2018, 93(1): 68-82. DOI: 10.1016/j.mayocp.2017.11.005.
    [53] MONK TG, WELDON BC, GARVAN CW, et al. Predictors of cognitive dysfunction after major noncardiac surgery[J]. Anesthesiology, 2008, 108(1): 18-30. DOI: 10.1097/01.anes.0000296071.19434.1e.
    [54] MERLI M, LUCIDI C, PENTASSUGLIO I, et al. Increased risk of cognitive impairment in cirrhotic patients with bacterial infections[J]. J Hepatol, 2013, 59(2): 243-250. DOI: 10.1016/j.jhep.2013.03.012.
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出版历程
  • 收稿日期:  2020-02-02
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-05-15

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