Neurologic complications after solid organ transplantation.
Neurologic complications are common after solid organ transplantation and are associated with significant morbidity. Approximately one-third of transplant recipients experiences neurologic alterations with incidence ranging from 10% to 59%. The complications can be divided into such of those common to all types of transplant and others of those specific to transplanted organ. The most common complication seen with all types of transplanted organ is neurotoxicity attributable to immunosuppressive drugs, followed by seizures, opportunistic central nervous system (CNS) infections, cardiovascular events, encephalopathy and de novo CNS neoplasms. Amongst immunosuppressants, calcineurin inhibitors are the main drugs involved in neurotoxicity, leading to complications which ranges from mild symptoms, such as tremors and paresthesia to severe symptoms, such as disabling pain syndrome and leukoencephalopathy. Neurologic complications of liver transplantation are more common than that of other solid organ transplants (13-47%); encephalopathy is the most common CNS complication, followed by seizures; however, central pontine myelinolysis can appear in 1-8% of the patients leading to permanent disabilities or death. In kidney transplanted patients, stroke is the most common neurologic complication, whereas cerebral infarction and bleeding are more typical after heart transplantation. Metabolic, electrolyte and infectious anomalies represent common risk factors; however, identification of specific causes and early diagnosis are still difficult, because of patient's poor clinical status and concomitant systemic and metabolic disorders, which may obscure symptoms.
Senzolo
Marco
M
Gastroenterology, Department of Surgical and Gastroenterological Sciences, University Hospital of Padua, Padua, Italy.
Marco
Senzolo
S
Ferronato
Cecilia
C
Cecilia
Ferronato
F
Burra
Patrizia
P
Patrizia
Burra
B
D002493:Central Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects* / Q000706:statistics & numerical data; D015994:Incidence; D011183:Postoperative Complications / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors; D019737:Transplants / Q000009:adverse effects* / Q000706:statistics & numerical data