The clinical spectrum of neurologic disorders after intestinal and multivisceral transplantation

Abstract

Under high maintenance immunosuppression, intestinal transplant recipients were at high risk for neurologic complications. Future studies are needed to describe post-transplant neurologic complications with modern immunosuppression protocols.

The Neurology of Solid Organ Transplantation

“…Highest prevalence of seizures was reported in intestinal allograft recipients at 17 %, followed by lung and liver transplant recipients, occurring in 6-8 % of patients [6,8,9]. In kidney and heart transplant recipients, seizures have been reported in 1-6 and 2 % of patients, respectively [12].…”

“…Postoperative unresponsiveness may result from complications of surgical procedure of transplantation, major metabolic disturbances, or drug reaction. In multiple series, encephalopathy was the most common complication after transplantation, especially during the first few weeks [5,6,8,9,14]. Intraoperative cardiac arrest leading to cerebral hypoperfusion and anoxic brain injury is probably the most feared complication with high morbidity and mortality.…”

“…Cerebrovascular complications have been reported in up to 7 % of lung transplant patients (5 % ischemic stroke; 2 % hemorrhage) [8]. Ischemic stroke and hemorrhage have been reported in 4 % of patients after intestinal and multivisceral transplantation (each), with ischemic strokes presenting in patients with hypercoagulable disorders in the setting of subtherapeutic anticoagulation [9]. In liver transplant patients, ischemic stroke occurs in 0.5-2 % of patients, and 1-2 % of transplant recipients may suffer cerebral hemorrhage [5,6].…”

“…Posttransplant clinical course is often complicated by a wide spectrum of infectious, toxic, and metabolic disturbances, and various neurologic complications affect up to 30-60 % of SOT recipients [3][4][5][6][7][8][9][10][11][12]. Prevalence is highest after lung and intestinal transplantation, but overall survival is usually not affected [4,8,9].…”

“…Prevalence is highest after lung and intestinal transplantation, but overall survival is usually not affected [4,8,9]. Most of neurologic complications are common to all solid organ transplants, but few are relatively specific for individual allograft types (Table 1).…”