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Neuropathology of Heart Transplantation

Published online by Cambridge University Press:  18 September 2015

L.C. Ang*
Affiliation:
Department of Pathology, University Hospital and the University of Western Ontario, London
J.M. Gillett
Affiliation:
Department of Clinical Neurological Sciences, University Hospital and the University of Western Ontario, London
J.C.E. Kaufmann
Affiliation:
Department of Pathology, University Hospital and the University of Western Ontario, London
*
Department of Pathology (Neuropathology), University of Saskatchewan, Health Sciences Building, Saskatoon, Saskatchewan, Canada S7N 0W0
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Abstract:

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The neuropathology of 18 cardiac transplant recipients was reviewed with the clinical findings. Pathological changes were noted in the central nervous system (CNS) in 94% of the patients, the most frequent being cerebral vascular in origin (72%). Eight patients (44%) had multiple cerebral infarcts and morphologically, a large number of these antedated the transplantation. In addition 4 patients had acute focal ischemic changes which occurred after transplantation. Intracranial hemorrhage was noted in 5 patients (28%), including one case of fatal intracerebral hemorrhage following an acute hypertensive episode after the transplantation. While systemic infection was common (10 patients), there were only 5 cases of intracranial infection; including 3 cases of cytomegalovirus infection, one of candidiasis and one of aspergillosis. Post-transplant seizures, occurring in a third of the patients, were related to a variety of causative factors such as sepsis, intracranial hemorrhage, cerebral ischemia, metabolic encephalopathy and cyclosporin neurotoxicity. Of note in this series was the absence of CNS lymphoma or other systemic lymphoproliferative disorder.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1989

References

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