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논문 기본 정보

자료유형
학술저널
저자정보
Kim Minwoo (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Kim Jae Hyun (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Park Wonhyoung (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Park Jung Cheol (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Ahn Jae Sung (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Kwun Byung Duk (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Lee Sung-Gyu (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea.) Hwang Shin (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea.) Kim Moinay (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.) Lee Seungjoo (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.39 No.9
발행연도
2024.3
수록면
1 - 15 (15page)
DOI
10.3346/jkms.2024.39.e88

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초록· 키워드

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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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