Neurological Complications and Organ Rejection in Transplant. Is there a Connection? (P4.158)

OBJECTIVE: Assessing the connection between SNC and organ rejection in a population of transplant patients. BACKGROUND: Encephalopathy, epileptic seizures and status epilepticus (SE) are severe neurological complications (SNC) that are frequently encountered in transplant patients. Their etiologies are multiple. Organ rejection has been reported as one of them. The clinical scenario where it should be suspected is unclear. DESIGN/METHODS: A retrospective study evaluating neurological events that took place in transplant patients admitted at Favaloro Foundation in the period 2006-2014. We selected SNC, excluding central nervous system infections and structural lesions as their etiology. We determined the presence of organ rejection during the patients’ hospital stay, or the posterior three months. RESULTS: 228 neurology consults. 60[percnt](n=137) SNC, 31[percnt](n=42) were encephalopathies, and 69[percnt](n=94) were epileptic seizures. 26.5[percnt](n=25) of the seizures presented with SE. 33[percnt](n=45) of the patients presented organ rejection among the first three months after the event. 38[percnt] of mortality in this group. 80[percnt](n=36) of the organ rejections took place at the moment of the neurologic evaluation. 62[percnt](n=28) of the patients with organ rejection presented epileptic seizures, 36[percnt](n=10) of which presented with SE. 38[percnt](n=17) suffered encephalopathy of other etiologies. 24[percnt](n=11) of the SNC with organ rejection took place during the first 7 days after the transplant. 18[percnt](n=8) took place between days 7 and 30. 58[percnt](n=26) happened after the first month of transplantation. CONCLUSIONS: A relevant percentage of our population of transplant patients presented SNC in the context of organ rejection. Although this is a very complex group of patients that usually presents with concomitant systemic complications, we believe that organ rejection should be consider as an option when other etiologies of the SNC are less clear. New studies are needed in order to establish if SNC of unknown etiology may be considered indirect markers of organ rejection. Study Supported by: Disclosure: Dr. Gonzalez Toledo has nothing to disclose. Dr. Calle has received personal compensation for activities with UCB Pharma as a scientific advisory board member. Dr. Nadile has nothing to disclose. Dr. Pagani Cassara has nothing to disclose. Dr. Tamargo has nothing to disclose. Dr. Thomson has nothing to disclose. Dr. Thomson has nothing to disclose.