Objective: Here we report on the largest population of solid organ transplant recipients that was investigated with clinical neurophysiological methods, to objectively establish the tremor prevalence and the tremor syndrome.

Background: This study is part of TransplantLines, a prospective cohort study of transplant recipients.¹

Method: We examined heart, kidney, liver and lung recipients. Kidney donors served as a healthy group. Tremor was measured using bilateral triaxial accelerometers in resting and four postural positions, two of which were repeated as loaded conditions using a one-kilogram weight. Tremor amplitude and frequency were calculated per task. Healthy participants’ tremor amplitude was used to determine the presence of tremor in transplant recipients, defined as exceeding the 95^th percentile. In transplant recipients with objectified tremor, tremor frequency, frequency variability, and effect of loading were used to investigate enhanced physiological tremor as the likely tremor syndrome.

Results: Tremor was present in 52% of 248 transplant recipients, typically in a postural position, rather than at rest. Median tremor frequency was 6.2 Hz, 45% of patients had a tremor frequency >6 Hz. Median tremor variability was 2.3 Hz, 63% of patients had a frequency variability >1.75 Hz. The mean effect of loading was 2.1 and 1.1 Hz depending on the posture, 83% of patients had a frequency decrease of >1 Hz in loaded versus unloaded conditions. When combining all three neurophysiological features indicative of enhanced physiological tremor, 65% of patients met the formal criteria.²

Conclusion: We established that half of the patients exhibit tremor after solid organ transplantation, in the first study in which tremor prevalence was measured objectively. The tremor characteristics best fit the syndrome of enhanced physiological tremor.

References: 1. Eisenga MF, Gomes-Neto AW, van Londen M, et al. Rationale and design of TransplantLines: a prospective cohort study and biobank of solid organ transplant recipients. BMJ Open. 2018;8(12):e024502. doi:10.1136/bmjopen-2018-024502 2. van der Stouwe AMM, Elting JW, van der Hoeven JH, et al. How typical are ‘typical’ tremor characteristics? Sensitivity and specificity of five tremor phenomena. Park Relat Disord. 2016;30. doi:10.1016/j.parkreldis.2016.06.008

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MDS Abstracts - https://www.mdsabstracts.org/abstract/tremor-after-organ-transplantation-prevalence-and-characteristics/