Neuropsychiatric complications due to organ transplantation: a survey of 1499 Brazilian patients at a single center in São Paulo, Brazil

The objective of this study was to compare the frequency of neuropsychiatric complications over time in transplant recipients (TRs) at a single large transplant center. This was a retrospective analysis of 1499 patients who underwent organ transplantation at Hospital das Clínicas of Sao Paulo University School of Medicine from 1965 to 2001. Neuropsychiatric complications were observed in 463 TRs (30.9%). Neuroinfections were the most frequent ones (36.9%) and Cryptococcus neoformans was the most common agent (25.7%). Cerebrovascular disease occurred in 19.9% and the ischemic mechanism was more prevalent (71.7%) than hemorrhage. Neurotoxicity was present in 15.2% and cyclosporine was responsible for 75.7%. Neuromuscular disorders were diagnosed in 15.6%, whereas 41.7% of these TRs had radiculopathy associated with herpes zoster virus. Graft-versus-host disease occurred in 2.7% of TRs. These results may reflect the unique experience of the transplant population in Brazil and in their pre- and posttransplant medical management.