Delirium Among Adults Undergoing Solid Organ Transplantation

AbstractPurpose of ReviewTo summarize the research on postoperative delirium among patients undergoing solid organ transplantation in efforts to improve recognition, evaluation, and management, as well as highlight areas for future research.Recent FindingsDelirium is a common complication in patients with organ failure before and after undergoing solid organ transplant (range: 4.7 –47%). However, it is frequently unrecognized and underdiagnosed—even among those closely monitored after major surgery—given that its manifestation is often variable and inconsistent. Delirium has multifactorial etiologies comprising of a complex mix of predisposing recipient, donor, and tran splant factors, as well as intraoperative and perioperative factors. Evidence suggests that delirium risk increases with presence of a greater number of such risk factors and can lead to adverse outcomes such as increased hospital length of stay, time in the ICU, time on mechanical ventilators, graf t dysfunction, graft loss, and mortality. Though no trials have been conducted among transplant populations specifically, delirium has been shown to be preventable among hospitalized older adults generally. Multicomponent, primary prevention strategies designed to target multiple risk factors of del irium, such as cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment, and dehydration, have been identified as most effective. Whether these approaches translate to improvement...

Source: Current Transplantation Reports - March 23, 2021 Category: Transplant Surgery Source Type: research