FK506-INDUCED FULMINANT LEUKOENCEPHALOPATHY AFTER SINGLE-LUNG TRANSPLANTATION

FK506 is being used increasingly to prevent rejection after organ tran splantation. Its use is associated with a wide spectrum of neurotoxici ty, which has been described after most solid organ transplantations, but reports after lung transplantation are extremely rare. This is a r eport of the pathologic correlation of the clinical and radiologic fea tures of delayed FK506-induced fulminant leukoencephalopathy after sin gle-lung transplantation. The patient presented with neurologic sympto ms that progressed to seizure activity. Neuroimaging showed diffuse ch anges in the brain, and results of a brain biopsy were consistent with leukoencephalopathy with microglial and astrocytic activation. The pa tient had a remarkable improvement in clinical status after discontinu ation of FK506 administration, with resolution of the changes seen on neuroimaging. (C) 1997 by The Society of Thoracic Surgeons.