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Updated: May 15, 2026
Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
One-year functional and neuropsychological outcomes of liver transplant recipients undergoing prolonged mechanical
Mamatha Bhat1,2,3,4,5, Hannah Wozniak5, Victor Dong6
1Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Ontario, Canada.
Background:
Liver transplantation (LT) is increasingly performed on patients with comorbidities, including critically ill individuals requiring extended intensive care unit (ICU) care. Little is known about these recipients' long-term functional and neuropsychological outcomes. This study aimed to assess the impact of prolonged ICU stays and mechanical ventilation on LT recipients.
Methods:
We examined 1-year outcomes of LT recipients with prolonged mechanical ventilation (MV) exceeding 7 days in the multicentre RECOVER program (2009-2014). Assessments occurred at 7 days and 3, 6, and 12 months post-ICU discharge, focusing on the functional independence measure (FIM), Medical Research Council (MRC), 6-minute walk test (6MWT), and short-form-36 (SF-36) survey. Psychological assessment used the impact of event scale (IES) and Beck depression inventory-II (BDI-II). Caregivers' psychological outcomes were also evaluated.
Results:
Fourteen LT recipients (42.9% male; mean age 50 years) with median MV of 16.5 (14.0-25.8) days were included; 13 survived to ICU discharge (median ICU stay 19.5 [15.5-31.2] days). FIM scores showed persistent cognitive and motor function limitations, plateauing at 3 months. At 12 months, total FIM was 87.7 (SD 48.1), indicating moderate assistance need. The 6MWT was 71.6% predicted; SF-36 physical component score was 44.6 SD 9.1. Average BDI-II of 9.9 (SD 13.8) at 1 year indicated minimal depressive symptoms; mean IES score (24.4 SD 28.8) suggested post-traumatic stress disorder symptoms. Caregivers also experienced persistent depressive symptoms.
Conclusions:
LT recipients with prolonged MV exhibited lasting functional and cognitive limitations at 1-year follow-up, underscoring the potential benefits of targeted rehabilitation interventions for enhanced recovery.
