Delayed neuropsychologic dysfunction after liver transplantation for acute liver failure: A matched, case-control study

Elizabeth W. Jackson, Steven Zacks, Sandra Zinn, John Ryan, Mark W. Johnson, David A. Gerber, Kenneth Andreoni, Jeffrey H. Fair, Roshan Shrestha, Michael W. Fried

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Although several studies have identified posttransplant neurologic sequelae in patients with acute liver failure (ALF), the effects of these sequelae on neuropsychologic functioning after transplant is unknown. This study compared neuropsychologic functioning of ALF patients with chronic liver disease patients after liver transplantation. After liver transplantation, seven ALF patients were compared with a matched control group of patients who had been transplanted for chronic liver disease. The patients were matched by gender, age (within 5 years), and time since transplantation (within 2 years). Patients completed a 2-hour battery of tests, which included measures of attention, memory, motor performance, abstract conceptualization, and visuospatial perception. There were no significant differences between the groups on measures of socioeconomic status or education. Significant differences were found on three separate tests: WAIS-III Vocabulary, WAIS-III Similarities, and WMS-III Paired Associate Learning II. Although these tests measure distinct functions (vocabulary knowledge, abstract conceptualization, and delayed verbal recall), they may be influenced by broader verbal functions, such as verbal fluency, conceptualization, and the ability to articulate ideas. When patients were asked what functions had noticeably deteriorated since transplantation, nearly all complained of memory difficulties, and there was no difference between groups. However, more ALF than chronic liver disease (CLD) patients complained of concentration difficulties. The results of this study suggest that ALF patients may experience more neuropsychologic dysfunction after transplant. Further studies are required to expand on these initial observations with the potential to improve patient care and referral to appropriate rehabilitative service.

Original languageEnglish (US)
Pages (from-to)932-936
Number of pages5
JournalLiver Transplantation
Issue number10
StatePublished - Oct 1 2002
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation


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