Neurocritical Care

, Volume 28, Issue 1, pp 4–11 | Cite as

Neurologic Complications of Transplantation

  • Rajat Dhar
Review Article


Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10–30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.


Organ transplantation Stem cell transplantation Immunosuppressive agents Postoperative complications Posterior reversible encephalopathy syndrome 


Compliance with Ethical Standards

Conflict of interest

Rajat Dhar is a consultant for Mid-America Transplant, an Organ Procurement Organization and Member of the Executive Committee of the Organ Donation Research Consortium.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of Neurology (Division of Neurocritical Care)Washington University in St. Louis School of MedicineSaint LouisUSA

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