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Prevalence of cerebrovascular diseases that can cause hemorrhagic stroke in liver transplantation recipients: a 6-year comparative study with 24,681 healthy adults

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Abstract

Background and purpose

Cerebrovascular diseases are a leading cause of mortality after liver transplantation (LT). The prevalence of potentially hemorrhagic cerebrovascular diseases (HCVDs) that could cause a hemorrhagic stroke in patients with severe liver diseases has not been reported. We aimed to analyze the underlying prevalence of HCVDs that could lead to hemorrhagic strokes in LT recipients compared with that in previously healthy controls.

Methods

A retrospective study with 1,920 consecutive LT recipients and 24,681 adults who underwent a health checkup during the same period was conducted (January 2011–December 2016). The prevalence of cerebral aneurysms (CA), cerebral arteriovenous malformation (AVM), and cavernous malformation (CM) was evaluated using brain imaging, including computed tomography angiography, magnetic resonance imaging, magnetic resonance angiography, and digital subtraction angiography.

Results

The prevalence of CA and CM were 3.1% and 0.5%, respectively, in the LT group and 3.8% and 0.4%, respectively, in the control group. According to the location of the cerebral artery, paraclinoid internal carotid artery aneurysms (odds ratio [OR] 0.440; P = 0.009) had a lower prevalence in LT recipients than in healthy controls. Anterior communicating artery (OR 3.080; P = 0.002) and superior cerebellar artery (OR 8.767; P = 0.017) aneurysms had a higher prevalence in the LT group than in the control. The prevalence of AVM was significantly higher in LT recipients (0.26%) than in healthy controls (0.06%).

Conclusion

LT recipients showed a different distribution of CA prevalence according to the locations of the cerebral artery and had a higher overall prevalence of AVM than previously healthy controls.

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Authors and Affiliations

  1. Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yeongu Chung

  2. Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Yeongu Chung, Seungjoo Lee, Jung Cheol Park, Jae Sung Ahn, Eun Ji Moon, Jung Won Park & Wonhyoung Park

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  1. Yeongu Chung
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  2. Seungjoo Lee
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Contributions

Y. Chung: validation, formal analysis, investigation, data curation. and original draft preparation

S. Lee, J.C. Park and J.S. Ahn: conceptualization, software and review for original draft

E.J. Moon and J.W. Park: data curation and review for original draft

W. Park: conceptualization, methodology, and editing for original draft

Corresponding author

Correspondence to Wonhyoung Park.

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The authors declare that they have no conflicts of interest.

Ethics approval

This study was approved by institutional review board of Asan Medical Center (AMC IRB 2017-0838 and 2017-0882).

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The institutional review board of Asan Medical Center waived the informed consent requirement owing to the retrospective design of the study.

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Not applicable.

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Chung, Y., Lee, S., Park, J.C. et al. Prevalence of cerebrovascular diseases that can cause hemorrhagic stroke in liver transplantation recipients: a 6-year comparative study with 24,681 healthy adults. Neurol Sci 42, 2753–2761 (2021). https://doi.org/10.1007/s10072-020-04863-y

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  • DOI: https://doi.org/10.1007/s10072-020-04863-y

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