461 INCOMPLETE REVERSAL OF COGNITIVE DYSFUNCTION AFTER LIVER TRANSPLANTATION IN INDIVIDUALS WHO HAD HAD OVERT HEPATIC ENCEPHALOPATHY BEFORE LIVER TRANSPLANTATION

Results: The MTHFR C677T homozygote mutation (TT) was found in 28 (21%) patients, while the remaining 107 (79%) were wild types or heterozygotes (C/*). TT as compared to C/* patients had significantly higher DMELD-score (0.329±0.093 vs 0.146±0.096 means±SE, respectively; p < 0.01) before LT. At multivariate analysis, TT genotype was independently associated with MELD-score worsening during the waiting list (OR 5.21, lower 95% C.L 1.33, upper 95% C.L 20.31, p = 0.018), after adjustment for patient age, PL-MELD score, sex, portal vein thrombosis and cirrhosis aetiology. Post-transplant patient survival was significantly (Log-Rank test p = 0.007) lower in TT (median follow-up 27 months; range 0.1–85 months) than in C/* (median follow-up 33 months; range 0.1– 102 months) recipients. At Cox regression analysis, recipient TT genotype was independently associated with post-transplant patient survival (OR 2.44, lower 95% C.L 1.22, upper 95% C.L 4.84, p = 0.011), after adjustment for recipient age, LT-MELD score, sex, HCV status, and donor risk index. Conclusions: Cirrhotic patients with the MTHFR C677T homozygous mutation have faster disease progression before LT and worse survival after LT.