Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review
Background. Cognitive impairment is common among patients with cirrhosis and may persist post-transplantation. This systematic review seeks to (1) describe the prevalence of cognitive impairment in liver transplant (LT) recipients with a history of cirrhosis, (2) describe risk factors for this popul...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-05-01
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| Series: | Transplantation Direct |
| Online Access: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001479 |
| _version_ | 1797817528252104704 |
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| author | Osama M. Siddiqui, BS Archit B. Baskaran, MD Katherine A. Lin, BS Naela Najam Tahir Shah, BS Candidate Molly L. Beestrum, MLIS Avesh Thuluvath, MD Borna Bonakdarpour, MD Minjee Kim, MD Zachary Dietch, MD Michael Wolf, MD, MPH Daniela P. Ladner, MD, MPH |
| author_facet | Osama M. Siddiqui, BS Archit B. Baskaran, MD Katherine A. Lin, BS Naela Najam Tahir Shah, BS Candidate Molly L. Beestrum, MLIS Avesh Thuluvath, MD Borna Bonakdarpour, MD Minjee Kim, MD Zachary Dietch, MD Michael Wolf, MD, MPH Daniela P. Ladner, MD, MPH |
| author_sort | Osama M. Siddiqui, BS |
| collection | DOAJ |
| description | Background. Cognitive impairment is common among patients with cirrhosis and may persist post-transplantation. This systematic review seeks to (1) describe the prevalence of cognitive impairment in liver transplant (LT) recipients with a history of cirrhosis, (2) describe risk factors for this population, and (3) describe associations between post-transplant cognitive impairment and quality outcome measures.
Methods. Studies in PubMed, Embase, Scopus, PsychINFO, and the Cochrane Database of Controlled Trials were included through May 2022. Inclusion criteria included (1) population – LT recipient, age ≥18 y, (2) exposure – history of cirrhosis before transplant, and (3) outcome – cognitive impairment after transplant (per validated cognitive testing). Exclusion criteria included (1) wrong study type, (2) abstract-only publication, (3) full-text unavailable, (4) wrong population, (5) wrong exposure, and (6) wrong outcome. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Appraisal tool for Cross-Sectional Studies. The Grading of Recommendations, Assessment, Development, and Evaluations system was used to assess evidence certainty. Data from individual tests were categorized into six cognitive domains: attention, executive function, working memory, long-term memory, visuospatial, and language.
Results. Twenty-four studies were included covering 847 patients. Follow-up ranged from 1 mo to 1.8 y after LT. Studies had a median of 30 (interquartile range 21.5–50.5) patients. The prevalence of cognitive impairment after LT ranged from 0% to 36%. Forty-three unique cognitive tests were used, the most common being the Psychometric Hepatic Encephalopathy Score. The most frequently assessed cognitive domains were attention (10 studies) and executive function (10 studies).
Conclusions. The prevalence of cognitive impairment after LT varied across studies depending on cognitive tests utilized and follow-up duration. Attention and executive function were most impacted. Generalizability is limited due to small sample size and heterogeneous methodology. Further studies are needed to examine differences in the prevalence of post-LT cognitive impairment by etiology, risk factors, and ideal cognitive measures. |
| first_indexed | 2024-03-13T08:54:44Z |
| format | Article |
| id | doaj.art-e21927b64c524ecc84dbb37776067dc2 |
| institution | Directory Open Access Journal |
| issn | 2373-8731 |
| language | English |
| last_indexed | 2024-03-13T08:54:44Z |
| publishDate | 2023-05-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Transplantation Direct |
| spelling | doaj.art-e21927b64c524ecc84dbb37776067dc22023-05-29T03:49:52ZengWolters KluwerTransplantation Direct2373-87312023-05-0195e147910.1097/TXD.0000000000001479202305000-00005Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic ReviewOsama M. Siddiqui, BS0Archit B. Baskaran, MD1Katherine A. Lin, BS2Naela Najam3Tahir Shah, BS Candidate4Molly L. Beestrum, MLIS5Avesh Thuluvath, MD6Borna Bonakdarpour, MD7Minjee Kim, MD8Zachary Dietch, MD9Michael Wolf, MD, MPH10Daniela P. Ladner, MD, MPH111 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine, Northwestern University, Chicago, IL.2 Department of Neurology, University of Chicago Medical Center, University of Chicago, Chicago, IL.1 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine, Northwestern University, Chicago, IL.1 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine, Northwestern University, Chicago, IL.3 Department of Neuroscience, University of Cincinnati, Cincinnati, OH.4 Galter Health Sciences Library, Feinberg School of Medicine, Northwestern University, Chicago, IL.5 Division of Gastroenterology and Hepatology, Department of Medicine, Northwestern Medicine, Chicago, IL.6 Division of Behavioral Neurology, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.7 Division of Neurocritical Care, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL.8 Division of Transplant, Department of Surgery, Northwestern Medicine, Chicago, IL.9 Division of General Internal Medicine & Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.1 Northwestern University Transplant Outcomes Research Collaborative (NUTORC), Comprehensive Transplant Center (CTC), Feinberg School of Medicine, Northwestern University, Chicago, IL.Background. Cognitive impairment is common among patients with cirrhosis and may persist post-transplantation. This systematic review seeks to (1) describe the prevalence of cognitive impairment in liver transplant (LT) recipients with a history of cirrhosis, (2) describe risk factors for this population, and (3) describe associations between post-transplant cognitive impairment and quality outcome measures. Methods. Studies in PubMed, Embase, Scopus, PsychINFO, and the Cochrane Database of Controlled Trials were included through May 2022. Inclusion criteria included (1) population – LT recipient, age ≥18 y, (2) exposure – history of cirrhosis before transplant, and (3) outcome – cognitive impairment after transplant (per validated cognitive testing). Exclusion criteria included (1) wrong study type, (2) abstract-only publication, (3) full-text unavailable, (4) wrong population, (5) wrong exposure, and (6) wrong outcome. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Appraisal tool for Cross-Sectional Studies. The Grading of Recommendations, Assessment, Development, and Evaluations system was used to assess evidence certainty. Data from individual tests were categorized into six cognitive domains: attention, executive function, working memory, long-term memory, visuospatial, and language. Results. Twenty-four studies were included covering 847 patients. Follow-up ranged from 1 mo to 1.8 y after LT. Studies had a median of 30 (interquartile range 21.5–50.5) patients. The prevalence of cognitive impairment after LT ranged from 0% to 36%. Forty-three unique cognitive tests were used, the most common being the Psychometric Hepatic Encephalopathy Score. The most frequently assessed cognitive domains were attention (10 studies) and executive function (10 studies). Conclusions. The prevalence of cognitive impairment after LT varied across studies depending on cognitive tests utilized and follow-up duration. Attention and executive function were most impacted. Generalizability is limited due to small sample size and heterogeneous methodology. Further studies are needed to examine differences in the prevalence of post-LT cognitive impairment by etiology, risk factors, and ideal cognitive measures.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001479 |
| spellingShingle | Osama M. Siddiqui, BS Archit B. Baskaran, MD Katherine A. Lin, BS Naela Najam Tahir Shah, BS Candidate Molly L. Beestrum, MLIS Avesh Thuluvath, MD Borna Bonakdarpour, MD Minjee Kim, MD Zachary Dietch, MD Michael Wolf, MD, MPH Daniela P. Ladner, MD, MPH Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review Transplantation Direct |
| title | Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review |
| title_full | Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review |
| title_fullStr | Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review |
| title_full_unstemmed | Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review |
| title_short | Cognitive Impairment in Liver Transplant Recipients With a History of Cirrhosis: A Systematic Review |
| title_sort | cognitive impairment in liver transplant recipients with a history of cirrhosis a systematic review |
| url | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001479 |
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