A - 95 State of the Science Systematic Review of the Neuropsychology of Solid Organ Transplantation.

Abstract

Organ failure is associated with cognitive dysfunction; however, the acute and longitudinal effects of different types of organ failure and transplantation on cognition have yet to be fully elucidated. This systematic review aimed to identify evidence for key neurocognitive profiles by organ type among pre- and post-transplant patients and identify health and behavior factors that may influence cognition in transplant populations. PubMed, EMBASE, and PsychInfo database systemic searches were performed. The primary inclusion criteria were adult patients, peer-reviewed articles, full-organ transplant, and neuropsychological test results. Screening and data extraction were performed independently by two authors following PRISMA criteria. A total of 737 abstracts were screened, 237 full-text articles were reviewed for relevance in the second-level screening process, and a total of 125 articles were thoroughly reviewed and included. The number of studies by organ type included the following: liver (62), kidney (30), cardiac (17), lung (12), and multi-organ (4). Available research reported diffuse impairments in liver and cardiac transplant candidates, more circumscribed deficits (i.e., attention, executive functioning, and memory) in kidney transplant candidates, and few cognitive impairments among lung transplant candidates. Post-transplant research showed notable improvement across all organ recipients. Results appear to be impacted by disease severity and demographic variables, with older age more often associated with worse cognitive performance over time. Results highlight the several literature gaps that can be improved with further transplant neuropsychology research.