We aimed to analyze characteristics of
encephalopathy after both hematopoietic stem cell and solid organ pediatric
transplantation. We retrospectively reviewed medical records of 662 pediatric transplant recipients (201 with
liver transplantation [LT], 55 with
heart transplantation [HT], and 67 with
kidney transplantation [KT], 339 with allogeneic
hematopoietic stem cell transplantation [HSCT]) who received their graft organs at Asan Medical Center between January 2000 and July 2014. Of the 662 patients, 50 (7.6%) experienced
encephalopathy after
transplantation. The incidence of
encephalopathy was significantly different according to the type of organ transplant: LT, 16/201 (8.0%), HT, 13/55 (23.6%), KT, 5/67 (7.5%), and HSCT, 16/339 (4.7%) (P < 0.001). Drug-induced
encephalopathy (n = 14) was the most common
encephalopathy for all transplant types, but particularly after HSCT.
Hypertensive encephalopathy was the most common after KT and HT, whereas
metabolic encephalopathy was the most common after LT. The median time to
encephalopathy onset also differed according to the transplant type: 5 days after KT (range 0-491 days), 10 days after HT (1-296 days), 49.5 days after HSCT (9-1,405 days), and 39 days after LT (1-1,092 days) (P = 0.018). The mortality rate among patients with
encephalopathy was 42.0% (n = 21/50). Only 5 patients died of neurologic complications. Transplant-associated
encephalopathy presented different characteristics according to the type of transplant. Specialized diagnostic approach for neurologic complications specific to the type of transplant may improve survival and quality of life in children after
transplantation.