Risk Factors and Outcome of Cerebrovascular Complications in Transplant Recipients (P14-5.013)

Abstract

<h3>Objective:</h3> To determine the incidence of cerebrovascular complications, risk factors, and outcomes in transplant patients. <h3>Background:</h3> Post-Transplant patients experience a myriad of cerebrovascular (CV) complications including ischemic stroke (IS), TIA, SAH, ICH, and posterior reversible encephalopathy syndrome (PRES). These increase mortality and morbidity in an already susceptible population. <h3>Design/Methods:</h3> Retrospective observational study. Population: Patients ≥18 years of age who underwent solid organ transplantation since 2012 at a tertiary care center. Patients were divided into 2 groups, with CV complications and without. Outcomes of interest were the proportion of CV complications, length of stay (LOS), discharge disposition, functional outcomes (defined by a mRS), and survival time post-transplant. <h3>Results:</h3> A total of 94 patients met the inclusion criteria (31% with CV complications vs 69% patients without). The median age was 57.5 years (51.41 vs 45.75). IS was the most prevalent CV complication (n=13, 44%, most common etiology was cryptogenic 76.9% (n=11)) followed by ICH (n=6, 20%), and most of the complications occurred within 1 year post-transplant (n=17, 58.6%). A previous TIA or stroke predisposed to more CV complication post-transplant (OR 0.66 vs 4.89, p=0.05) but no difference was found for other risk factors when compared to recipients without complications. Patients with complications were more likely to have lung transplants (24.1% vs 1.5%, p&lt;0.05) and to be discharged to hospice (6.9% vs 0%, p&lt;0.05) or dead (27.6% vs 0%, p&lt;0.05) than those without complications, who were more likely to have kidney transplants (20.4% vs 79.6%, p&lt;0.05) and to be discharged home (17% vs 66%, p&lt;0.001). There was no difference for the other outcomes. <h3>Conclusions:</h3> Post-transplant patients, especially lung recipients, have a high incidence of CV complications and high mortality. A history of TIA or IS predisposes this population to subsequent CV events. LOS, demographic characteristics, use of antithrombotics, or survival time post-transplant was no different between groups. <b>Disclosure:</b> Dr. Cadena Tejada has nothing to disclose. Dr. Ozark has nothing to disclose. Dr. Gregoski has nothing to disclose. Dr. Grewal has nothing to disclose.