Early Cognitive Improvement One Month after Liver Transplant Measured by the NIH Toolbox

M. Kim¹, J. D. Peipert², K. J. Reid¹, E. M. Liotta¹, M. B. Maas¹, D. R. Ganger³, P. C. Zee¹, D. P. Ladner⁴

¹Neurology, Northwestern University, Chicago, IL, ²Medical Social Sciences, Northwestern University, Chicago, IL, ³Medicine, Northwestern University, Chicago, IL, ⁴Surgery, Northwestern University, Chicago, IL

Meeting: 2019 American Transplant Congress

Abstract number: B303

Keywords: Liver cirrhosis, Liver transplantation, Morbidity, Outcome

Session Information

Session Name: Poster Session B: Liver Retransplantation and Other Complications

Session Type: Poster Session

Date: Sunday, June 2, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Cognitive impairment (CI) is highly prevalent in liver cirrhosis. Improvement after liver transplant (LT) varies among patients, diminishing the benefits of LT for some. We aimed to assess pre-to-post-LT cognitive changes one month after LT using the NIH Toolbox (NIHTB), a standardized, quantitative, and validated cognition assessment tool that can be administered on an iPad in under 15 minutes.

*Methods: Baseline cognitive function was assessed using the NIHTB in 130 LT waitlist registrants randomly selected from the Northwestern Medicine Pre-LT Clinic (age 58±10; 64% men; MELD-Na 14±5.3; etiology 35% alcoholic, 22% nonalcoholic steatohepatitis, 29% viral hepatitis, 14% others). Of those, 11 patients (age at transplant 59±8; 82% men; MELD-Na 16±5.6; etiology 27% alcoholic, 36% viral hepatitis, 36% others) underwent LT within 12 months of baseline assessment and a repeat NIHTB assessment one month after LT.

*Results: Cognitive function was worse in LT waitlist registrants compared to demographic-matched U.S. population (40.2±8.6 vs. 50±10, p<0.001), consistent with prior studies that used traditional neuropsychological testing methods. Cognitive function improved one month after LT compared to baseline (40.1±9.0 vs. 43.3±10.7, p=0.016).

*Conclusions: NIHTB is a sensitive and practical cognitive assessment tool to detect early cognitive changes after LT. An in-progress longitudinal study with a larger sample size will help confirm these preliminary findings and identify predictors of individual cognitive changes.

To cite this abstract in AMA style:

Kim M, Peipert JD, Reid KJ, Liotta EM, Maas MB, Ganger DR, Zee PC, Ladner DP. Early Cognitive Improvement One Month after Liver Transplant Measured by the NIH Toolbox [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/early-cognitive-improvement-one-month-after-liver-transplant-measured-by-the-nih-toolbox/. Accessed November 22, 2024.

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