Analytic review: Neurological complications of transplantation

Research output: Contribution to journalReview article

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.

Original languageEnglish (US)
Pages (from-to)209-222
Number of pages14
JournalJournal of Intensive Care Medicine
Volume26
Issue number4
DOIs
StatePublished - Jul 1 2011

Keywords

  • brain tumors
  • encephalitis
  • encephalopathy
  • immune suppression
  • myopathy
  • organ transplantation
  • polyneuropathy
  • stroke

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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