Cognitive Function, Self-Management, and Health Outcomes among Liver Transplant Recipients: the LivCog Cohort

Our study objective is to investigate cognitive function over time among new (‘de novo’) liver transplant recipients and its impact on self-management capacity, health behaviors, and transplant outcomes. The prevalence of cirrhosis and end-stage liver disease (ESLD) in the U.S. has nearly doubled over the past two decades and is increasing among older adults. The demand for liver transplantation (LT), the only curative option for ESLD, will increase 23% by 2040 resulting in $26.7 billion/year in transplant-related healthcare costs. Advances in surgical techniques and immunosuppression have made deaths due to surgical complications or early rejection uncommon. The leading causes of long-term post-transplant mortality are now cardiovascular disease, malignancy and chronic kidney disease. Frailty and sarcopenia continue to be common physiologic consequences of ESLD that are associated with persistent post-transplant physical deficits. Despite restored liver function, less than half of LT recipients (LTRs) return to pre-transplant employment.