Hepatic Encephalopathy Clinical Trial
Official title:
Prediction of Mortality in Patients Waiting for Liver Transplantation Through Brain Magnetic Resonance Imaging
The purpose of this study is to determine whether hepatic encephalopathy, measured through magnetic resonance imaging, electroencephalogram and neuropsychological evaluation adds prognostic information to patients who are waiting for liver transplantation. If this model improves mortality prediction this might be used in the future for organ allocation.
The only current definitive treatment for end-stage liver disease is transplantation. Due to
the scarcity of organs available, the correct prioritization of patients for liver
transplantation has a crucial importance. Nowadays, patients are ranked according to
severity of liver disease, measured by the MELD score. This index is only derived from
objective measures (serum concentration of bilirubin, creatinine and INR). Hepatic
encephalopathy (HE) is a serious and progressive disorder in patients with end-stage liver
disease. The severity of HE has prognostic implications in those waiting for liver
transplantation. However, the prognosis of HE is independent and not correlated to the MELD
score. Hepatic encephalopathy triggers multiple changes in brain magnetic resonance imaging
(MRI) providing an objective way to evaluate it. Also electroencephalogram and
neuropsychological evaluation might increase mortality prediction.
Adding the information provided by MRI, electroencephalogram and neuropsychological
evaluation to the MELD score model might increase the prediction of mortality. Increase
mortality's prediction has a fundamental importance because in organ allocation.
We will evaluate the predictive value of these variables in predicting mortality of those
patients waiting for liver transplantation.
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Observational Model: Cohort, Time Perspective: Prospective
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