Changes in the brain during long-term follow-up after liver transplantation

Purpose:

To examine changes in the brain before liver transplantation caused by the accumulation of paramagnetic ion deposits and to investigate recovery after liver transplantation over a long‐term horizon.

Materials and Methods:

Fifteen patients indicated for liver transplantation, 26 patients up to 2 years after, and 40 patients 8–15 years after liver transplantation were subjected to MR relaxometry. T₁ and T₂ relaxation times in the basal ganglia, thalamus, and white matter were evaluated.

Results:

Relaxometry revealed a shortening of the relaxation times due to the deposition of paramagnetic ions in the basal ganglia before liver transplantation (P < 0.05), complete normalization of the relaxation times shortly after transplantation in the globus pallidus and caudate nucleus, and partial recovery of T₂ in the putamen. Relaxation times remained stable even 15 years posttransplantation. Increased relaxation times posttransplantation were found in the white matter and thalamus.

Conclusion:

The shortening of the relaxation times observed in the basal ganglia before liver transplantation was caused by paramagnetic ion deposition. The recovery observable within 2 years after transplantation was permanent, and no recurrence of paramagnetic ion deposition was observed even 15 years posttransplantation. Changes in the white matter and thalamus after transplantation were attributed to damage caused by permanent exposure to immunosuppressants. J. Magn. Reson. Imaging 2012;35:1332–1337. © 2012 Wiley Periodicals, Inc.