title: Neurological complications of transplantation.
abstract: Recipients of solid organ or hematopoietic cell transplants are at risk of life-threatening neurological disorders including encephalopathy, seizures, infections and tumors of the central nervous system, stroke, central pontine myelinolysis, and neuromuscular disorders-often requiring admission to, or occurring in, the intensive care unit (ICU). Many of these complications are linked directly or indirectly to immunosuppressive therapy. However, neurological disorders may also result from graft versus host disease, or be an expression of the underlying disease which prompted transplantation, as well as injury induced during radiation, chemotherapy, surgery, and ICU stay. In rare cases, neuroinfectious pathogens may be transmitted with the transplanted tissue or organ. Diagnosis may be a challenge because clinical symptoms and findings on neuroimaging lack specificity, and a biological specimen or tissue diagnosis is often needed for definitive diagnosis. Management is centered on preventing further neurological injury, etiology-targeted therapy, and balancing the benefits and toxicities of specific immunosuppressive agents.
authors.affiliation: Departments of Anesthesiology Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Aliaksei
authors.initials: A
authors.lastname: Pustavoitau
authors.forename: Anish
authors.initials: A
authors.lastname: Bhardwaj
authors.forename: Robert
authors.initials: R
authors.lastname: Stevens
mesh_terms: D001932:Brain Neoplasms / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007362:Intensive Care Units; D009135:Muscular Diseases / Q000209:etiology; D009422:Nervous System Diseases / Q000209:etiology*; D016377:Organ Transplantation / Q000009:adverse effects*; D012306:Risk; D020521:Stroke / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents