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Abstract Details

Risk Factors and Outcome of Cerebrovascular Complications in Transplant Recipients
Cerebrovascular Disease and Interventional Neurology
P14 - Poster Session 14 (11:45 AM-12:45 PM)
6-013

Post-Transplant patients experience a myriad of cerebrovascular (CV) complications including ischemic stroke (IS), TIA, SAH, ICH, and posterior reversible encephalopathy syndrome (PRES). These increase mortality and morbidity in an already susceptible population.

 

To determine the incidence of cerebrovascular complications, risk factors, and outcomes in transplant patients. 
Retrospective observational study. Population: Patients ≥18 years of age who underwent solid organ transplantation since 2012 at a tertiary care center. Patients were divided into 2 groups, with CV complications and without. Outcomes of interest were the proportion of CV complications, length of stay (LOS), discharge disposition, functional outcomes (defined by a mRS), and survival time post-transplant. 

A total of 94 patients met the inclusion criteria (31% with CV complications vs 69% patients without). The median age was 57.5 years (51.41 vs 45.75).  IS was the most prevalent CV complication (n=13, 44%, most common etiology was cryptogenic 76.9% (n=11)) followed by ICH (n=6, 20%), and most of the complications occurred within 1 year post-transplant (n=17, 58.6%). A previous TIA or stroke predisposed to more CV complication post-transplant (OR 0.66 vs 4.89, p=0.05) but no difference was found for other risk factors when compared to recipients without complications. Patients with complications were more likely to have lung transplants (24.1% vs 1.5%, p<0.05) and to be discharged to hospice (6.9% vs 0%, p<0.05) or dead (27.6% vs 0%, p<0.05) than those without complications, who were more likely to have kidney transplants (20.4% vs 79.6%, p<0.05) and to be discharged home (17% vs 66%, p<0.001). There was no difference for the other outcomes.

Post-transplant patients, especially lung recipients, have a high incidence of CV complications and high mortality. A history of TIA or IS predisposes this population to subsequent CV events. LOS, demographic characteristics, use of antithrombotics, or survival time post-transplant was no different between groups.  

 

Authors/Disclosures
Angel Joel Cadena Tejada, MD (Columbia University)
PRESENTER
Dr. Cadena Tejada has nothing to disclose.
Shelly D. Ozark, MD (Medical University of South Carolina) Dr. Ozark has nothing to disclose.
Mathew Gregoski, PhD (MUSC) Dr. Gregoski has nothing to disclose.
Parneet Kaur Grewal, MD (Medical University of South Carolina) Dr. Grewal has nothing to disclose.