Rejection encephalopathy

Thirteen patients are described who had 15 encephalopathic episodes complicating severe rejection crises following renal transplantation. Comparison was made with control rejection episodes in the same patients in which encephalopathy did not occur. The severity of the rejection episodes as measured by the rise in serum creatinine was significantly greater (p less than 0.05) in those episodes with encephalopathy than in control episodes. There was no difference from controls when comparison was made of mean arterial blood pressure (MABP) or rate of rise of MABP at the time of the encephalopathy. There was no significant difference in serum potassium, sodium and calcium, weight gain/fluid retention and immunosuppressive therapy in the two groups. Effective treatment of rejection and control of fits, hypertension and fluid retention produced rapid recovery without late sequelae.