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01-03-2019 | Thrombotic Microangiopathy | Editorial

Cerebral complications of solid organ transplantation

Authors: R. Sonneville, E. Mariotte, M. C. Brouwer

Published in: Intensive Care Medicine | Issue 3/2019

Excerpt

Solid organ transplantation (SOT) is a highly effective treatment in patients with end-stage organ failure, but is associated with a substantial risk of complications, including neurologic complications. Depending on the type of SOT and evaluated time frame, neurologic complications are described in between 10 and 21% of kidney transplant patients [1] and 33% of liver transplant patients in the perioperative period [2] and in 85% of heart transplant patients during 18 years of follow-up [3]. The spectrum of complications is broad, including postoperative delirium, peri-transplantation stroke, drug toxicity, central nervous system (CNS) infections and post-transplantation CNS lymphomas [4]. Here, we provide a practical approach to management of major neurologic complications in SOT patients admitted to the ICU. …

Potluri K, Holt D, Hou S (2014) Neurologic complications in renal transplantation. Handb Clin Neurol 121:1245–1255. https://doi.org/10.1016/B978-0-7020-4088-7.00084-5 CrossRef

Dhar R, Young GB, Marotta P (2008) Perioperative neurological complications after liver transplantation are best predicted by pre-transplant hepatic encephalopathy. Neurocrit Care 8:253–258. https://doi.org/10.1007/s12028-007-9020-4 CrossRef

van de Beek D, Kremers W, Daly RC et al (2008) Effect of neurologic complications on outcome after heart transplant. Arch Neurol 65:226–231. https://doi.org/10.1001/archneurol.2007.52 PubMed

Wright AJ, Fishman JA (2014) Central nervous system syndromes in solid organ transplant recipients. Clin Infect Dis 59:1001–1011. https://doi.org/10.1093/cid/ciu428 CrossRef

Lescot T, Karvellas CJ, Chaudhury P et al (2013) Postoperative delirium in the intensive care unit predicts worse outcomes in liver transplant recipients. Can J Gastroenterol 27:207–212CrossRef

Sher Y, Mooney J, Dhillon G et al (2017) Delirium after lung transplantation: association with recipient characteristics, hospital resource utilization, and mortality. Clin Transplant 31:e12966. https://doi.org/10.1111/ctr.12966 CrossRef

Anderson BJ, Chesley CF, Theodore M et al (2018) Incidence, risk factors, and clinical implications of post-operative delirium in lung transplant recipients. J Heart Lung Transplant 37:755–762. https://doi.org/10.1016/j.healun.2018.01.1295 CrossRef

Haugen CE, Mountford A, Warsame F et al (2018) Incidence, risk factors, and sequelae of post-kidney transplant delirium. J Am Soc Nephrol 29:1752–1759. https://doi.org/10.1681/ASN.2018010064 CrossRef

Buis CI, Wiesner RH, Krom RAF et al (2002) Acute confusional state following liver transplantation for alcoholic liver disease. Neurology 59:601–605CrossRef

10.

Karpe KM, Talaulikar GS, Walters GD (2017) Calcineurin inhibitor withdrawal or tapering for kidney transplant recipients. Cochrane Database Syst Rev 7:CD006750. https://doi.org/10.1002/14651858.CD006750.pub2 PubMed

11.

Al-Nouri ZL, Reese JA, Terrell DR et al (2015) Drug-induced thrombotic microangiopathy: a systematic review of published reports. Blood 125:616–618. https://doi.org/10.1182/blood-2014-11-611335 CrossRef

12.

Fugate JE, Rabinstein AA (2015) Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 14:914–925. https://doi.org/10.1016/S1474-4422(15)00111-8 CrossRef

13.

van Veen KEB, Brouwer MC, van der Ende A, van de Beek D (2016) Bacterial meningitis in solid organ transplant recipients: a population-based prospective study. Transpl Infect Dis 18:674–680. https://doi.org/10.1111/tid.12570 CrossRef

14.

Sonneville R, Magalhaes E, Meyfroidt G (2017) Central nervous system infections in immunocompromised patients. Curr Opin Crit Care 23:128–133. https://doi.org/10.1097/MCC.0000000000000397 CrossRef

15.

Claassen J, Taccone FS, Horn P et al (2013) Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM. Intensive Care Med 39:1337–1351. https://doi.org/10.1007/s00134-013-2938-4 CrossRef

Title: Cerebral complications of solid organ transplantation
Authors: R. Sonneville
E. Mariotte
M. C. Brouwer
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Keywords: Thrombotic Microangiopathy
Brain Abscess
Posterior Reversible Encephalopathy Syndrome
Calcineurin Inhibitors
Published in: Intensive Care Medicine / Issue 3/2019
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-019-05540-1

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