Progressive multifocal leukoencephalopathy fifty-seven months after heart transplantation.

Progressive multifocal leukoencephalopathy (PML), a subacute and usually fatal demyelinating disease of the brain, is caused by an opportunistic viral infection in immunocompromised patients. Only one case of PML after heart transplantation has been reported; it was discovered at the autopsy of a patient who died of multiorgan system failure. We describe an otherwise asymptomatic heart transplant recipient who had neurologic complaints that could be specifically attributed to PML, demonstrate the pertinent pathologic findings, and review the PML literature germane to heart transplantation. PML may become more prevalent as the population of heart transplant recipients increases.