title: Neurologic complications of transplantation.
abstract: Major neurologic morbidity, such as seizures and encephalopathy, complicates 20-30% of organ and stem cell transplantation procedures. The majority of these disorders occur in the early posttransplant period, but recipients remain at risk for opportunistic infections and other nervous system disorders for many years. These long-term risks may be increasing as acute survival increases, and a greater number of "sicker" patients are exposed to long-term immunosuppression. Drug neurotoxicity accounts for a significant proportion of complications, with posterior reversible leukoencephalopathy syndrome, primarily associated with calcineurin inhibitors (i.e., cyclosporine and tacrolimus), being prominent as a cause of seizures and neurologic deficits. A thorough evaluation of any patient who develops neurologic symptoms after transplantation is mandatory, since reversible and treatable conditions could be found, and important prognostic information can be obtained.
authors.affiliation: Division of Neurocritical Care, Department of Neurology, Washington University, St. Louis, MO, USA. Electronic address: dharr@neuro.wustl.edu.
authors.forename: R
authors.initials: R
authors.lastname: Dhar
mesh_terms: D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology*; D009894:Opportunistic Infections / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology*
keywords: calcineurin inhibitors; delirium; hematopoietic stem cell transplantation; opportunistic infections; organ transplantation; posterior reversible encephalopathy syndrome; seizure