TY  - JOUR
PY  - 2020//
TI  - Liver transplant is associated with sustained improvement in tandem gait and risk of falls
JO  - Digestive diseases and sciences
A1  - Acharya, Chathur
A1  - White, Melanie B.
A1  - Fagan, Andrew
A1  - Sterling, Richard K.
A1  - Stravitz, R. Todd
A1  - Puri, Puneet
A1  - Fuchs, Michael
A1  - Luketic, Velimir
A1  - Sanyal, Arun J.
A1  - Wade, James B.
A1  - Gilles, HoChong
A1  - Heuman, Douglas M.
A1  - Tinsley, Felicia
A1  - Matherly, Scott
A1  - Lee, Hannah
A1  - Siddiqui, Mohammad S.
A1  - Thacker, Leroy R.
A1  - Bajaj, Jasmohan S.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Cirrhosis is associated with poor health-related quality of life (HRQOL), cognitive dysfunction (CD), and lack of coordination leading to falls. Tandem gait (TG; heel-toe) can be used to assess coordination. The impact and relationship between CD, TG and falls pre-/post-liver transplant (LT) is unclear. We aimed to determine the impact of LT on CD, abnormal TG, and HRQOL in cirrhosis. <br><br>METHODS: We analyzed patients who underwent complete neurological examination, cognitive testing by psychometric hepatic encephalopathy score (PHES), and HRQOL assessment using sickness impact profile (SIP). All patients were followed for 1 post-LT visit at 6 or 12 months post-LT for clinical course and falls. Change in CD, TD, and falls pre-/post-LT were compared. <br><br>RESULTS: Off 131 recruited, 61 patients completed all visits. Majority were men (84%), with HCV etiology (34%). Pre-LT: Abnormal TG trended towards increased falls (OR 3.3, P = 0.08). Forty-nine % had abnormal TG, 61% had CD, 32.7% had CD + abnormal TG, 62% had prior OHE, and 14.7% had falls. Abnormal and normal TG patients had similar ages, BMI, sex, education level, and MELD scores. Abnormal TG group had higher prior overt HE (P = 0.03) and worse physical SIP score (P = 0.008). Post-LT: There was sustained improvement in CD, HRQOL, falls, and TG post-LT more at 12 than 6 months in all patients. Patients who had abnormal TG pre-LT continued to have a worse PHES (P = 0.0064) and physical SIP score (P = 0.008) compared to normal pre-LT TG patients. <br><br>CONCLUSION: After LT, there is a sustained improvement in coordination measured via tandem gait, accompanied by a lower rate of falls.<p />  <p>Language: en</p>
LA  - en
SN  - 0163-2116
UR  - http://dx.doi.org/10.1007/s10620-020-06261-y
ID  - ref1
ER  -