Current recommendations regarding evaluation of cognitive functioning in organ transplant candidates

Abstract

Purpose of reviewCognitive impairment is associated with negative effects on solid organ transplant candidates, recipients, and their care partners. However, because of the heterogeneity of mechanisms, presentations, and assessment measures, research suggests a wide array of impairments, patterns of impairments, and unclear trajectories posttransplant. This review provides an abbreviated synthesis of recent research on cognitive impairments observed in organ-eligible candidates and potential trajectories through posttransplant, current clinical recommendations regarding integration of assessment into routine clinical transplant practice, as well as recommendations for future research. Recent findingsTransplantation may resolve certain disease-contributing factors to cognitive impairments but also introduces new potential neurocognitive assaults. Recent studies in kidney and lung recipients document continued impairments in subsets of patients, particularly those identified as frail. For liver candidates, new assessment measures of hepatic encephalopathy have been developed and preliminarily tested with potential for translation into routine clinical care. Clinical implications, as well as ethical considerations are discussed.

Neuropsychological and biopsychosocial evolution, therapeutic adherence and unmet care needs during paediatric transplantation: study protocol of a mixed-methods design (observational cohort study and focus groups) – the TransplantKIDS mental health project

“…However, although these lines of intervention have been, to some extent, covered in some children hospitals, the scientific evidence accumulated to date identifies other areas of action that every reference hospital for paediatric transplantation should protocolize. In particular, these include standardized assessment of patients throughout the entire process (pre-, post-transplant and follow-up phases) on biopsychosocial (quality of life, emotional and behavioral problems) and neuropsychological domains ( Jesse and Haver, 2022 ), which will be the main objective of this project.…”