Outcome of gastric emptying and gastrointestinal symptoms after liver transplantation for hereditary transthyretin amyloidosis
Open accessAbstract
BACKGROUND: Hereditary transthyretin amyloid (ATTR) amyloidosis is a rare but fatal autosomal dominant condition that is present all over the world. A liver transplantation has been shown to halt the progress of the disease in selected patients and is currently considered to be the standard treatment. Gastrointestinal manifestations are common in hereditary ATTR amyloidosis and are important for the patients' morbidity and mortality. The aim of this study was to evaluate the long-term outcome of gastric emptying, gastrointestinal symptoms and nutritional status after liver transplantation for the disease. METHODS: Swedish patients with hereditary ATTR amyloidosis transplanted between 1990 and 2012 were included. A standardized method for measuring gastric emptying with a Tc(99m)-labelled meal followed by scintigraphy was utilized. Validated questionnaires were used to assess gastrointestinal symptoms and the modified body mass index (mBMI), in which BMI is multiplied by s-albumin, was used to evaluate nutritional status. Non-parametrical statistical tests were used. RESULTS: Gastric emptying rates and nutritional statuses were evaluated approximately eight months before and two and five years after liver transplantation, whereas gastrointestinal symptoms were assessed in median nine months before and two and nine years after transplantation. No significant change was found in gastric emptying (median half-time 137 vs. 132 vs. 125 min, p = 0.52) or nutritional status (median mBMI 975 vs. 991 vs. 973, p = 0.75) after transplantation. Gastrointestinal symptom scores, however, had increased significantly over time (median score 7 vs. 10 vs. 13, p < 0.01). CONCLUSIONS: Gastric emptying and nutritional status were maintained after liver transplantation for hereditary ATTR amyloidosis, although gastrointestinal symptom scores had increased over time.
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Advanced therapies can improve GI symptoms in selected patients with amyloidosis, including stem cell transplantation with cytotoxic therapy in systemic amyloidosis and liver transplantation in transthyretin amyloidosis.
“Advanced therapies can improve GI symptoms in selected patients, including stem cell transplantation with cytotoxic therapy in systemic amyloidosis and liver transplantation in transthyretin amyloidosis (Afrough et al., 2015; Wixner et al., 2015).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Wixner et al., 2015
For the liver-transplantation part attributed to Wixner et al., the Results (GI symptoms; page not specified) report that GI symptom prevalence and scores increased after transplantation. The Conclusions say gastric emptying and nutritional status were maintained, but GI symptom scores increased—not improved. The stem-cell-transplantation part is attributed to the other citation and is not judged here. (LLM, conf=0.91)
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Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction
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- Authors
- Wixner, J., Sundström, T., Karling, P., Anan, I., & Suhr, O. B.
- Affiliations
- Umeå University (SE)
- Corresponding author
- Wixner, Jonas
- Venue
- BMC Gastroenterology
- Published
- 2015-04-25
- Volume
- 15
- Issue
- 1
- Pages
- 51-51
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC4415350
- OpenAlex
- W1999260465
- Cited by
- 11
- References
- 45
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- hereditary transthyretin amyloidosis, liver transplantation, gastric emptying, gastrointestinal symptoms, nutritional status, long-term outcomes
- MeSH terms
- Adult, Aged, Constipation, Diarrhea, Female, Gastric Emptying, Humans, Male, Middle Aged, Nausea, Nutritional Status, Postoperative Period, Surveys and Questionnaires, Serum Albumin, Time Factors, Vomiting, Body Mass Index, Liver Transplantation, Age of Onset, Amyloid Neuropathies, Familial, Malnutrition, Young Adult
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