LAUSR

ObjectivesTo investigate the prevalence of cerebrovascular stenosis and white matter lesions on preoperative magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) in liver transplantation candidates.MethodsThis retrospective study included 1,460 consecutive patients with liver cirrhosis (LC) who underwent MRA with/without brain MRI for pretransplantation evaluation. These patients were matched with 5,331 controls using propensity scores, and the prevalences of significant cerebrovascular stenosis and white matter lesions were compared.ResultsA matched analysis of 1,264 pairs demonstrated that the prevalence of significant stenosis was comparable between LC patients and controls (2.2% vs. 1.4%, P = 0.143). LC and most of LC-related parameters were not associated with stenosis. Significant white matter lesions were more common in LC patients (2.8% vs. 1.3%, P = 0.036). A high Model for End-Stage Liver Disease (MELD) score (OR 1.11, CI 1.03–1.20, P = 0.008, for infarction; OR 1.1, CI 1.04–1.16, P = 0.001, for haemorrhage) and stroke history (OR 179.06, CI 45.19–709.45, P < 0.001) were predictors of perioperative stroke.ConclusionsLC patients and control subjects demonstrated similar cerebrovascular stenosis prevalences, whereas white matter lesions were more common in LC patients. A high MELD score and stroke history contribute as predictors of perioperative stroke.Key points• Routine preoperative MR imagingin liver transplantation candidates may not be necessary.• Liver cirrhosis patients and control subjects had similar prevalences of significant cerebrovascular stenosis.• Liver cirrhosis and cirrhosis-related parameters were not correlated with significant cerebrovascular stenosis.• Significant white matter lesions were more frequent in liver cirrhosis patients.