Neurocognitive correlates of end-stage organ dysfunction: the role of Transplant Neuropsychology

Abstract

End-stage organ failure (e.g. kidney, liver, heart, lung) is a critical medical illness and can result in death without solid organ transplantation. However, many patients present with cognitive deficits and challenges with adherence, which can limit access to life-saving transplant. In this session, we provided an overview of the medical and biopsychosocial factors impacting cognition among patients with end-stage organ disease. Dr. Kyle Jennette discussed the pathophysiology of organ dysfunction and relationships with the central nervous system (CNS) among those with liver, kidney, heart, and lung failure. Dr. Sarah Szymkowicz described neuropsychological profiles associated with those conditions, focusing on biopsychosocial factors and comorbid medical disease states that may impact cognition. Mrs. Amanda Messerlie explained the risks and benefits of solid organ transplant as a potential treatment for organ failure and associated cognitive difficulties. Finally, Dr. Jenessa Price integrated this information in a discussion of the specialty practice of Transplant Neuropsychology, including interpreting cognition in the context of the full biopsychosocial picture, framing transplant readiness based on the comprehensive evaluation, and delivering meaningful feedback within the multidisciplinary treatment team setting. Attendees increased clinical understanding of this medically complex population and gained insight on the specialty practice of Transplant Neuropsychology, toward the goal of increasing comprehensive neuropsychological care and access to transplant among those at-risk for cognitive difficulty.

Keywords: Transplant Neuropsychology; integrated neuropsychology; organ transplant.