J Korean Soc Transplant.  1998 Nov;12(2):327-337.

Neurologic Complications in Kidney Transplant Recipients

• Kwun WH
• Suh BY
• Kwun KB
• Do JY
• Park TC

Abstract

OBJECTIVE
Neurologic complications make a major contribution to morbidity and mortality in kidney transplant recipients. Most occur months or years after transplantation and may never come to the attention of the transplant surgeon. We report 5 cases of neurologic complications in kidney transplant recipients. Three of them were diagnosed as intracranial abscess by central nervous system infection and others were diagnosed as hypertensive encephalopathy. CASES: Three patients with intracranial abscess have experienced mild coughing, intermittent fever and pulmonary infection initially. During the treatment of pulmonary infection they experienced some of neurologic symptoms and signs, such as severe headache, loss of consciousness and dizziness. Brain MRI was performed and showed lesions of intracranial abscess. The etiologic organism were Nocardia in two cases and Staphylococcus epidermidis in one case. They were treated with stereotactic aspiration of abscess and antibiotics therapy. Two of them recovered but eventually one of them didn't recover. Two patients with hypertensive encephalopathy experienced severe headache, visual illusion and generalized seizure at the immediate postoperative period of kidney transplantation. Their systolic pressure was 190~210 mmHg and diastolic pressure was 140~150 mmHg. Brain MRI scan showed hyperintensity signals in T2WI and hypointensity signal in T1WI on bilateral occipital lobes. They were treated with antihypertensive agents and anticonvulsants. Seizure were well controlled and didn't recur.
CONCLUSION
Meaningful survival in post-transplant neurologic complications is dependent on rapid diagnosis and initiation of effective treatment.

Keyword

Renal transplantation; Brain abscess; Hypertensive encephalopathy

MeSH Terms

Abscess
Anti-Bacterial Agents
Anticonvulsants
Antihypertensive Agents
Blood Pressure
Brain
Brain Abscess
Central Nervous System Infections
Cough
Diagnosis
Dizziness
Fever
Headache
Humans
Hypertensive Encephalopathy
Illusions
Kidney Transplantation
Kidney*
Magnetic Resonance Imaging
Mortality
Neurologic Manifestations
Nocardia
Occipital Lobe
Postoperative Period
Seizures
Staphylococcus epidermidis
Transplantation*
Unconsciousness
Anti-Bacterial Agents
Anticonvulsants
Antihypertensive Agents