{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T11:25:01Z","timestamp":1773746701063,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background\/Objectives: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. Methods: In this retrospective study, we investigate the incidence and characteristics of tremor in kidney transplant patients and analyze its occurrence with respect to a multitude of demographic and clinical parameters, thereby aiming to confirm the role of calcineurin inhibitor-induced neurotoxicity and to identify other putative predictive factors. Furthermore, we characterize post-transplant tremor with the goal of identifying its clinical features and determining the impact on quality of life. Results: A total of 129 kidney transplant recipients were screened; six patients were excluded due to a history of movement disorders prior to kidney transplantation. In total, 123 patients were included in the final analysis\u201469 male (56%) and 54 female patients (44%), with a median age of 50. A total of 36% (46 patients) developed tremor in the post-transplant period. Using both univariable and multivariable analyses, we found that female sex and tacrolimus use were independently associated with the development of post-transplant tremor. In addition, multivariable analysis identified an association between younger age and post-transplant tremor. Furthermore, we observed a trend in the duration of symptoms in relation to the calcineurin inhibitor choice. Conclusions: Despite a relatively high prevalence (36%), post-transplant tremor does not significantly impact the QoL and spontaneously resolves within 1 year in adult kidney transplant recipients. Female sex and tacrolimus were identified as independent predictors of post-transplant tremor in renal transplant recipients.<\/jats:p>","DOI":"10.3390\/neurolint18030056","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:17:44Z","timestamp":1773742664000},"page":"56","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-Transplant Tremor: Characteristics and Differences Based on Sex and Post-Transplant Therapy"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1287-6144","authenticated-orcid":false,"given":"Srdjana","family":"Telarovic","sequence":"first","affiliation":[{"name":"School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia"},{"name":"Department of Neurology, University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Vrdoljak Pazur","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia"},{"name":"University Hospital for Infectious Diseases \u201cDr. Fran Mihaljevic\u201d, Mirogojska 8, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolina","family":"Zupancic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia"},{"name":"Department of Anesthesiology and Intensive Care, University Hospital Merkur, Zaj\u010deva 19, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anamarija","family":"Strajduhar","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia"},{"name":"Clinic for Pulmonary Diseases, University Hospital Centre Zagreb, Jordanovac 104, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1657-4650","authenticated-orcid":false,"given":"Irma","family":"Telarovic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Zagreb, Salata 3b, 10000 Zagreb, Croatia"},{"name":"Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Raemistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e36","DOI":"10.1016\/S0140-6736(12)60202-5","article-title":"The Global Role of Kidney Transplantation","volume":"379","author":"Garcia","year":"2012","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1056\/NEJMra2014530","article-title":"Long-Term Survival after Kidney Transplantation","volume":"385","author":"Hariharan","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1432-2277.2008.00780.x","article-title":"Neurologic Complications after Solid Organ Transplantation","volume":"22","author":"Senzolo","year":"2009","journal-title":"Transpl. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ncl.2009.09.011","article-title":"Neurologic Manifestations of Transplant Complications","volume":"28","author":"Zivkovic","year":"2010","journal-title":"Neurol. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.ncl.2017.06.013","article-title":"Neurologic Complications of Solid Organ Transplantation","volume":"35","author":"Pizzi","year":"2017","journal-title":"Neurol. Clin."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1016\/B978-0-7020-4088-7.00084-5","article-title":"Neurologic Complications in Renal Transplantation","volume":"Volume 121","author":"Potluri","year":"2014","journal-title":"Handbook of Clinical Neurology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/1744-9987.12838","article-title":"Neurological Complications after Renal Transplantation: A Systematic Review and Meta-Analysis","volume":"23","author":"Mohammadi","year":"2019","journal-title":"Ther. Apher. Dial."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1111\/j.1432-2277.2000.tb01004.x","article-title":"Neurotoxicity of Calcineurin Inhibitors: Impact and Clinical Management","volume":"13","author":"Bechstein","year":"2000","journal-title":"Transpl. Int."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zhang, W., Egashira, N., Masuda, S., Zhang, W., Egashira, N., and Masuda, S. (2019). Recent Topics on the Mechanisms of Immunosuppressive Therapy-Related Neurotoxicities. Int. J. Mol. Sci., 20.","DOI":"10.20944\/preprints201905.0358.v1"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1007\/s00415-018-8904-x","article-title":"Tremor Induced by Calcineurin Inhibitor Immunosuppression: A Single-Centre Observational Study in Kidney Transplanted Patients","volume":"265","author":"Erro","year":"2018","journal-title":"J. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/ctr.12581","article-title":"Switching Study of Kidney TRansplant pAtients with Tremor to LCP-TacrO (STRATO): An Open-Label, Multicenter, Prospective Phase 3b Study","volume":"29","author":"Langone","year":"2015","journal-title":"Clin. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Consensus Statement on the Classification of Tremors. From the Task Force on Tremor of the International Parkinson and Movement Disorder Society","volume":"33","author":"Bhatia","year":"2018","journal-title":"Mov. Disord."},{"key":"ref_13","first-page":"100061","article-title":"Immunosuppressive Regimens Following Kidney Transplantation in Five European Countries: The Observational RECORD Study","volume":"5","author":"Arnol","year":"2020","journal-title":"Transplant. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1111\/j.1600-6143.2009.02834.x","article-title":"Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group KDIGO Clinical Practice Guideline for the Care of Kidney Transplant Recipients","volume":"9","author":"Eckardt","year":"2009","journal-title":"Am. J. Transpl."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2","DOI":"10.5334\/tohm.725","article-title":"Phenomenology and Physiology of Tacrolimus Induced Tremor","volume":"13","author":"Lunny","year":"2023","journal-title":"Tremor Other Hyperkinet. Mov."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100815","DOI":"10.1016\/j.trre.2023.100815","article-title":"The Association between Tacrolimus Exposure and Tremor, Headache and Insomnia in Adult Kidney Transplant Recipients: A Systematic Review","volume":"38","author":"King","year":"2024","journal-title":"Transpl. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e16412","DOI":"10.1111\/ene.16412","article-title":"Tremor after Solid Organ Transplantation: Results from the TransplantLines Biobank and Cohort Study","volume":"31","author":"Riemersma","year":"2024","journal-title":"Eur. J. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1315","DOI":"10.1097\/MD.0000000000001315","article-title":"Association of Extrarenal Adverse Effects of Posttransplant Immunosuppression with Sex and ABCB1 Haplotypes","volume":"94","author":"Venuto","year":"2015","journal-title":"Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1002\/phar.2656","article-title":"Race and Sex Associations with Tacrolimus Pharmacokinetics in Stable Kidney Transplant Recipients","volume":"42","author":"Tornatore","year":"2022","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e14550","DOI":"10.1111\/ctr.14550","article-title":"Bioavailability of Once-Daily Tacrolimus Formulations Used in Clinical Practice in the Management of De Novo Kidney Transplant Recipients: The Better Study","volume":"36","author":"Rivera","year":"2022","journal-title":"Clin. Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s40268-023-00428-4","article-title":"Tremor Induced by Cyclosporine, Tacrolimus, Sirolimus, or Everolimus: A Review of the Literature","volume":"23","author":"Lunny","year":"2023","journal-title":"Drugs R D"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2050312116671725","DOI":"10.1177\/2050312116671725","article-title":"SF-36 Total Score as a Single Measure of Health-Related Quality of Life: Scoping Review","volume":"4","author":"Lins","year":"2016","journal-title":"SAGE Open Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"311","DOI":"10.5125\/jkaoms.2023.49.6.311","article-title":"Review of Two Immunosuppressants: Tacrolimus and Cyclosporine","volume":"49","author":"Lee","year":"2023","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/3\/56\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:39:46Z","timestamp":1773743986000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/18\/3\/56"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["neurolint18030056"],"URL":"https:\/\/doi.org\/10.3390\/neurolint18030056","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]}}}