Role of microvesicles as markers of inflammation and adverse clinical outcomes in orthotopic liver transplantation

Mesquita, Gabriela Lisiane Tripiquia Vechiatto; Yokoyama, Ana Paula Hitomi; Souza, Cinthia Madeira de; Kutner, José Mauro; Almeida, Márcio Dias de; Vaz, Camila de Oliveira; Santos, Ana Paula Rosa dos; Jachinto, Bruna Cardoso; Oliveira, José Diogo; Santos, Irene; Mazetto, Bruna de Moraes; Orsi, Fernanda Andrade

doi:10.1016/j.liver.2023.100138

Cited by 1 publication

(1 citation statement)

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“…Patients undergoing LT surgery typically belong to the elderly demographic and often present with concurrent medical conditions, including hypertension, smoking history, and atherosclerosis, 1 all of which are well-established risk factors for the development of unruptured intracranial aneurysms (UIAs). 10 Additionally, these patients commonly exhibit endothelial cell dysfunction and systemic inflammatory responses, 11 which might significantly influence the growth and rupture potential of UIAs. 12 Moreover, perioperative hypertensive episodes and coagulopathy are frequent occurrences in LT surgery, 13 further heightening the likelihood of UIA occurrence and rupture in this specific patient population.…”

Section: Introductionmentioning

confidence: 99%

Risk of Cerebral Aneurysm Rupture After Liver Transplantation: Development and Validation of a Hemorrhagic Stroke Scoring Model

Kim,

Park

et al. 2024

J Korean Med Sci

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Background Liver transplantation (LT) patients appear to be more prone to neurological events compared to individuals undergoing other types of solid-organ transplantation. The aims of the present study were to analyze the prevalence of unruptured intracranial aneurysms (UIAs) in patients undergoing liver transplantation (LT) and to examine the perioperative occurrence of subarachnoid hemorrhage (SAH). Also, it intended to systematically identify the risk factors of SAH and hemorrhagic stroke (HS) within a year after LT and to develop a scoring system which involves distinct clinical features of LT patients. Methods Patients who underwent LT from January 2012 to March 2022 were analyzed. All included patients underwent neurovascular imaging within 6 months before LT. We conducted an analysis of prevalence and radiological features of UIA and SAH. The clinical factors that may have an impact on HS within one year of LT were also reviewed. Results Total of 3,487 patients were enrolled in our study after applying inclusion and exclusion criteria. The prevalence of UIA was 5.4%. The incidence of SAH and HS within one year following LT was 0.5% and 1.6%, respectively. We developed a scoring system based on multivariable analysis to predict the HS within 1-year after LT. The variables were a poor admission mental status, the diagnosis of UIA, serum ammonia levels, and Model for End-stage Liver Disease (MELD) scores. Our model showed good discrimination among the development (C index, 0.727; 95% confidence interval [CI], 0.635–0.820) and validation (C index, 0.719; 95% CI, 0.598–0.801) cohorts. Conclusion The incidence of UIA and SAH was very low in LT patients. A poor admission mental status, diagnosis of UIA, serum ammonia levels, and MELD scores were significantly associated with the risk of HS within one year after LT. Our scoring system showed a good discrimination to predict the HS in LT patients.

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