Changes in the brain during long-term follow-up after liver transplantation.
OBJECTIVE
To examine changes in the brain before liver transplantation caused by the accumulation of paramagnetic ion deposits and to investigate recovery after liver transplantation over a long-term horizon.


METHODS
Fifteen patients indicated for liver transplantation, 26 patients up to 2 years after, and 40 patients 8-15 years after liver transplantation were subjected to MR relaxometry. T(1) and T(2) relaxation times in the basal ganglia, thalamus, and white matter were evaluated.


RESULTS
Relaxometry revealed a shortening of the relaxation times due to the deposition of paramagnetic ions in the basal ganglia before liver transplantation (P < 0.05), complete normalization of the relaxation times shortly after transplantation in the globus pallidus and caudate nucleus, and partial recovery of T(2) in the putamen. Relaxation times remained stable even 15 years posttransplantation. Increased relaxation times posttransplantation were found in the white matter and thalamus.


CONCLUSIONS
The shortening of the relaxation times observed in the basal ganglia before liver transplantation was caused by paramagnetic ion deposition. The recovery observable within 2 years after transplantation was permanent, and no recurrence of paramagnetic ion deposition was observed even 15 years posttransplantation. Changes in the white matter and thalamus after transplantation were attributed to damage caused by permanent exposure to immunosuppressants.
MR Unit, Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. vit.herynek@medicon.cz
Vít
V
Herynek
Dita
D
Wagnerová
Irena
I
Hejlová
Monika
M
Dezortová
Milan
M
Hájek
D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects* / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged