Ethical, Legal, Psychosocial, And Financial IssuesImplications of impaired cognition for organ transplant candidacyArciniegas, David B. MD*†; Filley, Christopher M. MD*‡Author Information *Departments of Psychiatry and Neurology, University of Colorado Health Sciences Center, Denver, Colorado, USA. †Psychiatry Service and ‡Neurology Service, Denver Veterans Affairs Medical Center, Denver, Colorado, USA Correspondence to D.B. Arciniegas, MD, Campus Box C268-68, 4200 East Ninth Avenue, Denver, CO 80262, USA; e-mail: firstname.lastname@example.org Current Opinion in Organ Transplantation: June 1999 - Volume 4 - Issue 2 - p 168 Buy Abstract Cognitive impairment may present a serious problem for some patients who require organ transplantation for continued survival, and adds complexity to the difficult task of assessing organ transplant candidacy. In this article, we provide a framework for considering the potential impact of transplantation on impaired cognition. We suggest that an individualized approach to determining organ transplant candidacy in these patients is reasonable because cognitive impairment cannot be considered an absolute contraindication to transplantation. Patients with primary organ failure that is directly responsible for cognitive dysfunction may experience significant cognitive improvement following organ transplant, and in such cases the presence of cognitive impairment may indicate a more urgent need for transplantation. Those with additional cognitive dysfunction due to unrelated neurologic causes cannot be expected to do as well as patients without added dysfunction; however, many patients with static encephalopathy can also benefit from such procedures. Further research is necessary to clarify criteria for organ transplant candidacy in individuals with cognitive impairment. © 1999 Lippincott Williams & Wilkins, Inc.