Neurologic complications after heart transplantation

Arquivos de Neuro-Psiquiatria

Suzana M.f. Malheiros²  Dirceu R. Almeida¹  Ayrton R. Massaro²  Adauto Castelo¹  Rosiane V.z. Diniz¹  João N. Branco¹  Antonio C. Carvalho¹  Alberto A. Gabbai² 

[1] ,Universidade Federal de São Paulo Escola Paulista de Medicina Department of Neurology

关键词: heart transplantation;    postoperative complications;    Chagas' disease;    cardiomyopathy;    stroke;    transplante cardíaco;    complicações pós-operatórias;    doença de Chagas;    miocardiopatia;    transtornos cerebrovasculares;   

DOI  :  10.1590/S0004-282X2002000200002

来源: SciELO

【 摘 要 】

OBJECTIVE: Neurologic complications are known as important cause of morbidity and mortality in orthotopic heart transplantation. Our aim was to identify the frequency and outcome of neurologic complications after heart transplantation in a prospective observational study. METHOD: From September 93 to September 99, as part of our routine heart transplantation protocol all patients with end-stage cardiac failure were evaluated by the same neurologist before and at the time of any neurologic event (symptom or complaint) after transplantation. RESULTS: Out of 120 candidates evaluated, 62 were successfully transplanted (53 male; median age 45.5 years, median follow-up 26.8 months). Fifteen patients (24%) had ischemic, 22 (35%) idiopathic, 24 (39%) Chagas' disease and 1 (2%) had congenital cardiomyopathy. Neurologic complications occurred in 19 patients (31%): tremor, severe headache, transient encephalopathy and seizures related to drug toxicity or metabolic changes in 13; peripheral neuropathy in 4; and spinal cord compression in two (metastatic prostate cancer and epidural abscess). No symptomatic postoperative stroke was observed. CONCLUSIONS: Although frequent, neurologic complications were seldom related to persistent neurologic disability or death. Most of the complications resulted from immunosuppression, however, CNS infection was rare. The absence of symptomatic stroke in our series may be related to the lower frequency of ischemic cardiomyopathy.

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