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

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
doi: 10.1371/journal.pone.0222934



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.


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.


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.


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:

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


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