Cerebral hemorrhage in recipients of renal transplantation

Objective: The causes and circumstances of intracerebral hematoma after kid ney transplantation have been poorly studied, No data are available on its impact on outcome after a successful renal grafting. Patients and Methods: We used the Mayo Clinic medical diagnostic index to i dentify the patients with a diagnosis of intracerebral hematoma among the 1 573 patients who received a renal transplant at the Mayo Clinic between 196 6 and 1998. Results: Ten intracranial hematomas occurred in 9 patients and were the cau se of death in 6 (1%) of the 530 patients known to have died. The interval from renal transplantation to intracranial hematoma ranged from 12 to 114 m onths (average, 57 months). All patients with intracranial hemorrhage had p oorly controlled hypertension. Intracranial hematoma was more frequently an d significantly associated with autosomal dominant polycystic kidney diseas e (4/146 [2.7%]; P<.01) and with diabetes mellitus (3/410 [0.7%]; P<.01) th an with other underlying causes of renal failure (2/1017 [0.2%]). Conclusion: In this preliminary study, the risk of cerebral hemorrhage may have increased 10-fold in patients with autosomal dominant polycystic kidne y disease and 4-fold in patients with diabetes mellitus, when compared with the population of patients having other causes of renal failure. Most cere bral hemorrhages mere catastrophic and fatal but appeared to be responsible for only 1% of the deaths after renal transplantation.