Postoperative cognitive dysfunction in heart transplantation recipients

Clin Transplant. 2024 May;38(5):e15337. doi: 10.1111/ctr.15337.


Objective: This study aimed to investigate the occurrence and risk factors of postoperative neurocognitive disorder (NCD) in patients who underwent heart transplantation.

Methods: Seventy-six heart transplant patients were analyzed for clinical data including gender, age, height, weight, education level, left ventricular ejection fraction (LVEF), stroke volume (SV), transplantation duration, and pretransplant medical history. Cognitive function was assessed using the mini-mental status examination (MMSE) and Montreal cognitive assessment (MoCA) scales. Patients were categorized into cognitively normal and impaired groups based on the presence or absence of cognitive dysfunction, and their cognitive function scores were compared. Multivariate logistic regression was used to identify independent risk factors for cognitive impairment in postoperative cardiac transplant patients.

Results: Cognitive dysfunction was observed in 48 out of 76 heart transplant patients, representing an incidence of 63.2%. Cognitive impairment in heart transplant recipients predominantly affected multiple cognitive domains. Logistic regression analysis identified age (OR = 1.057, 95% CI 1.002-1.115), gender (OR = .200, 95% CI .044-.919), education level (OR = .728, 95% CI .600-.883), LVEF (OR = .891, 95% CI .820-.969), and history of diabetes (OR = 7.674, 95% CI 1.317-44.733) as independent risk factors for postoperative NCD in heart transplant recipients (P < .05).

Conclusion: The study found a high incidence of postoperative NCD in heart transplant patients, with gender, age, education level, LVEF, and diabetes history being significant risk factors. Early identification and intervention targeting these risk factors may help prevent NCD in postheart transplant patients and improve long-term outcomes.

Keywords: heart transplantation; neuropsychological test; postoperative neurocognitive disorder; risk factor.

MeSH terms

  • Adult
  • Cognitive Dysfunction* / epidemiology
  • Cognitive Dysfunction* / etiology
  • Female
  • Follow-Up Studies
  • Heart Transplantation* / adverse effects
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Postoperative Cognitive Complications / epidemiology
  • Postoperative Cognitive Complications / etiology
  • Postoperative Complications / etiology
  • Prognosis
  • Retrospective Studies
  • Risk Factors