Walter Steven Bartynski MD, Presenter: Nothing to Disclose

John F Boardman MD, Abstract Co-Author: Nothing to Disclose

J. Wallace Marsh MD, Abstract Co-Author: Nothing to Disclose

Paolo Fontes, Abstract Co-Author: Nothing to Disclose

Henkie Tan MD,PhD, Abstract Co-Author: Nothing to Disclose

R. Shapiro, Abstract Co-Author: Nothing to Disclose

To assess the frequency and clinical characteristics of Posterior Reversible Encephalopathy Syndrome (PRES) after Solid Organ Transplantation (SOTx).

Patients who developed PRES after SOTx were retrospectively identified from the radiology MR imaging report data base assessed over a 7 year period and confirmed by image inspection. The type of transplant was noted and clinical timing and events surrounding the development of PRES were identified and tabulated.

PRES developed in 13 of 3138 SOTx’s (0.4%) performed within the study period to include: Liver- 6 of 1125 (0.53%), Kidney- 2 of 1060 (0.19%), Heart- 1 of 247 (0.4%), Lung- 1 of 323 (0.3%), Kidney-Pancreas- 1 of 184 (0.54%) and Small Bowel- 1 of 56 (1.79%). These differences were not statistically significant. An additional 4 cases of PRES were identified that were transplanted prior to the study period. Liver Tx’s typically developed PRES in the first 4 months after Tx and were associated with CMV antigenemia or systemic bacterial infection. Kidney Tx’s typically developed PRES 12 months or more after Tx and were commonly associated with bacterial infection or transplant rejection. The other Tx’s were more variable in timing and demonstrated a mixture of CMV expression, bacterial infection and/or rejection in association with PRES.

SOT’s have a similar incidence of developing PRES but the time point of toxicity and clinical associations differ with the type of transplant. Infectious/immune related sequella including CMV, infection and rejection appear to be common associations during the development of PRES after SOT.

This is the first comprehensive assessment of PRES in Solid Organ Transplantation and establishes its overall and organ specific frequency and suggests important clinical associations/causes.

Bartynski, W, Boardman, J, Marsh, J, Fontes, P, Tan, H, Shapiro, R, Posterior Reversible Encephalopathy Syndrome (PRES) in Solid Organ Transplantation.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4430566.html