The Neurology of Solid Organ Transplantation

Abstract

Transplantation is the rescue treatment for end-stage organ failure with more than 110,000 solid organs transplantations performed worldwide annually. Recent advances in transplantation procedures and posttransplantation management have improved long-term survival and quality of life of transplant recipients, shifting the focus from acute perioperative critical care needs toward long-term chronic medical problems. Neurologic complications affect up to 30-60 % of solid organ transplant recipients. Common etiologies include opportunistic infections and toxicities of antirejection medications, and wide spectrum of toxic and metabolic disturbances. Most complications are common to all allograft types, but some are relatively specific for individual allograft types (e.g., central pontine myelinolysis in liver transplant recipients). Close collaboration between neurologists and other transplant team members is essential for effective management. Early recognition of complications and accurate diagnosis leading to timely treatment is essential to reduce the morbidity and improve the overall transplant outcome.

Insight Into the Metabolomic Characteristics of Post-Transplant Diabetes Mellitus by the Integrated LC-MS and GC-MS Approach- Preliminary Study

“…Solid organ transplantation (SOT), with more than 110,000 transplantations performed worldwide annually ( 1 ), is the treatment of choice for patients with end-stage organ failure. The short-term outcome of SOT improved remarkably due to advances in organ preservation ( 2 ), surgical techniques ( 3 ), immunosuppression regimens ( 4 ) and so on.…”

Incidence, Etiology, and Outcomes of Altered Mental Status in the Perioperative Setting of Liver Transplantation

“…3,8 However, upon initial presentation, it may be difficult to determine the underlying cause of a neurologic abnormality, particularly perioperatively, given a high incidence of pretransplant hepatic encephalopathy, and postoperatively associated with medication and/or metabolic shifts associated with improved function of the transplanted liver. 2,8,10,11 Altered mental status is among the most common reasons prompting neurologic consultation from liver transplantation specialists. As these cases may require urgent action, initial recommendations for workup are often provided via telephone prior to a full examination.…”

“…Neurologic complications of orthotopic liver transplantation (OLT) are well described, with estimated incidences ranging between around 15% and 45%. 1 –9 These complications range from transient encephalopathies associated with toxic, metabolic, and/or infectious etiologies to permanent neurologic injury caused by ischemic stroke, intracranial hemorrhage, or osmotic myelinolysis. 3,8 However, upon initial presentation, it may be difficult to determine the underlying cause of a neurologic abnormality, particularly perioperatively, given a high incidence of pretransplant hepatic encephalopathy, and postoperatively associated with medication and/or metabolic shifts associated with improved function of the transplanted liver.…”

“…3,8 However, upon initial presentation, it may be difficult to determine the underlying cause of a neurologic abnormality, particularly perioperatively, given a high incidence of pretransplant hepatic encephalopathy, and postoperatively associated with medication and/or metabolic shifts associated with improved function of the transplanted liver. 2,8,10,11…”

Neurological Complications After Renal Transplantation: A Systematic Review and Meta‐Analysis

“…Nowadays, in most of the centers, the survival probability has increased by 90% up to 5 years after the kidney transplantation. However, over the later years, patients will suffer from new diseases and even rare neurological disorders . Some of the neurological disorders are resulted from inherent disorders leading to kidney transplantation or dialysis .…”