Quantitative magnetic resonance imaging indicates brain tissue alterations in patients after liver transplantation

English version

Autoři: Lukas Laurids Goede ^aff001; Henning Pflugrad ^aff001; Birte Schmitz ^aff002; Heinrich Lanfermann ^aff002; Anita Blanka Tryc ^aff001; Hannelore Barg-Hock ^aff004; Jürgen Klempnauer ^aff004; Karin Weissenborn ^aff001; Xiao-Qi Ding ^aff002
Působiště autorů: Department of Neurology, Hannover Medical School, Hannover, Germany ^aff001; Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany ^aff002; Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany ^aff003; Clinic for Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany ^aff004
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222934

Souhrn

Purpose

To investigate cerebral microstructural alterations in patients treated with calcineurin inhibitors (CNI) after orthotopic liver transplantation (OLT) using quantitative magnetic resonance imaging (qMRI) and a cross-sectional study design.

Methods

Cerebral qMRI was performed in 85 patients in a median 10 years after OLT compared to 31 healthy controls. Patients were treated with different dosages of CNI or with a CNI-free immunosuppression (CNI-free: n = 19; CNI-low: n = 36; CNI-standard: n = 30). T2-, T2*- and T2’- relaxation times, as well as apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured in brain gray and white matter by using the regions of interest method.

Results

In comparison to controls, patients revealed significantly increased T2, T2*, T2’, ADC and reduced FA, predominantly in the frontal white matter, indicating microstructural brain alterations represented by increased free water (increased T2), reduced neuronal metabolism (increased T2’) and a lower degree of spatial organization of the nervous fibers (reduced FA). CNI-low and CNI-free patients showed more alterations than CNI-standard patients. Analysis of their history revealed impairment of kidney function while under standard CNI dose suggesting that these patients may be more vulnerable to toxic CNI side-effects.

Conclusion

Our findings suggest that the individual sensitivity to toxic side effects should be considered when choosing an appropriate immunosuppressive regimen in patients after liver transplantation.

Klíčová slova:

Diffusion tensor imaging – Central nervous system – Magnetic resonance imaging – Kidneys – Immunosuppressives – Liver transplantation – Microstructure – Relaxation time

Zdroje

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