{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:54:00Z","timestamp":1760151240246,"version":"build-2065373602"},"reference-count":14,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive\/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predicts acute NCs in over 65-year-old liver transplant patients. Methods: Data were collected, from a retrospective medical chart review, of 22 deceased donor liver transplant recipients aged 65 years or older with a pre-operative brain magnetic resonance imaging (MRI). We used the Fazekas score (0\u20133) as a quantitative measurement of the vascular lesion load seen in the MRI. We analyzed all post-operative acute NCs occurring during the hospital stay and any other non-NC. Results: cSVD was recognized in all patients. Neurological complications (NCs) occurred in 18.1% of patients with toxic-metabolic encephalopathy the most frequent diagnosis (13.64%). More severe cSVD was associated with seizures (p = 0.0362), longer hospital stay (p 0.0299), and disability (p 0.0134). In our elderly cohort, hepatic encephalopathy (HE) (p 0.0287) and ascites (p 0.0270) were predictors of NCs after liver transplantation. Ascites and\/or variceal bleeding and severity of liver disease were associated with adverse post-operative outcomes. The small sample size limited the statistical analysis power. Conclusions: We present the preliminary data of a single-center retrospective study aimed at understanding the cSVD role on NCs and non-NCs after a liver transplantation in elderly patients. This would encourage a more appropriate multicenter prospective study that will definitely confirm if a neurological screening in old age liver transplant candidates is appropriate.<\/jats:p>","DOI":"10.3390\/neurolint14010019","type":"journal-article","created":{"date-parts":[[2022,2,27]],"date-time":"2022-02-27T20:48:33Z","timestamp":1645994913000},"page":"245-255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center Experience"],"prefix":"10.3390","volume":"14","author":[{"given":"Federica","family":"Avorio","sequence":"first","affiliation":[{"name":"Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4787-1634","authenticated-orcid":false,"given":"Gianvincenzo","family":"Sparacia","sequence":"additional","affiliation":[{"name":"Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"},{"name":"Radiology Service, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Russelli","sequence":"additional","affiliation":[{"name":"Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelio","family":"Seidita","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Mamone","sequence":"additional","affiliation":[{"name":"Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Alduino","sequence":"additional","affiliation":[{"name":"Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Tuzzolino","sequence":"additional","affiliation":[{"name":"Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9684-8035","authenticated-orcid":false,"given":"Salvatore","family":"Gruttadauria","sequence":"additional","affiliation":[{"name":"Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"},{"name":"Department of Surgery and Surgical and Medical Specialties, University of Catania, 95124 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Miraglia","sequence":"additional","affiliation":[{"name":"Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3269-935X","authenticated-orcid":false,"given":"Matteo","family":"Bulati","sequence":"additional","affiliation":[{"name":"Research Department, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5313-5166","authenticated-orcid":false,"given":"Vincenzina","family":"Lo Re","sequence":"additional","affiliation":[{"name":"Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1002\/lt.21089","article-title":"Liver transplantation in those of advancing age: The case for transplantation","volume":"13","author":"Lipshutz","year":"2007","journal-title":"Liver Transplant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/00007890-199101000-00046","article-title":"Liver transplantation in patients over sixty years of age","volume":"51","author":"Stieber","year":"1991","journal-title":"Transplantation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1097\/00007890-199808270-00015","article-title":"Age and liver transplantation: A report of the Liver Transplantation 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Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"5548","DOI":"10.3748\/wjg.v22.i24.5548","article-title":"Comprehensive risk assessment for early neurologic complications after liver transplantation","volume":"22","author":"Wu","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1002\/lt.22383","article-title":"Changing picture of central nervous system complications in liver transplant recipients","volume":"17","author":"Vizzini","year":"2011","journal-title":"Liver Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/j.jtcvs.2006.11.036","article-title":"Chronic ischemic cerebral white matter disease is a risk factor for nonfocal neurologic injury after total aortic arch replacement","volume":"133","author":"Lin","year":"2007","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"409","DOI":"10.4254\/wjh.v5.i8.409","article-title":"Neurologic complications after liver transplantation","volume":"5","year":"2013","journal-title":"World J. Hepatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"275","DOI":"10.3389\/fneur.2014.00275","article-title":"Predictive factors of neurological complications and one-month mortality after liver transplantation","volume":"5","author":"Fu","year":"2014","journal-title":"Front. 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