Transplant Infectious Disease Program, Massachusetts General Hospital.
Transplant Infectious Disease Program, Massachusetts General Hospital Transplant Center, Harvard Medical School, Boston, Massachusetts.
Clin Infect Dis. 2014 Oct;59(7):1001-11. doi: 10.1093/cid/ciu428. Epub 2014 Jun 9.
Solid organ transplant recipients have a high incidence of central nervous system (CNS) complications, including both focal and diffuse neurologic deficits. In the immunocompromised host, the initial clinical evaluation must focus on both life-threatening CNS infections and vascular or anatomic lesions. The clinical signs and symptoms of CNS processes are modified by the immunosuppression required to prevent graft rejection. In this population, these etiologies often coexist with drug toxicities and metabolic abnormalities that complicate the development of a specific approach to clinical management. This review assesses the multiple risk factors for CNS processes in solid organ transplant recipients and establishes a timeline to assist in the evaluation and management of these complex patients.
实体器官移植受者中枢神经系统（CNS）并发症发生率高，包括局灶性和弥漫性神经功能缺损。在免疫功能低下的宿主中，初始临床评估必须同时关注危及生命的中枢神经系统感染和血管或解剖病变。为预防移植物排斥反应而进行的免疫抑制会改变 CNS 病变的临床体征和症状。在这一人群中，这些病因常与药物毒性和代谢异常并存，使临床管理的具体方法变得复杂。本综述评估了实体器官移植受者 CNS 病变的多种危险因素，并制定了时间线，以协助评估和管理这些复杂患者。
