Neuropathy after Transplant

Some patients experience neuropathy (nerve damage) after transplant.

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Two types of nerve damage can occur after transplant: peripheral neuropathy and autonomic neuropathy.

Neuropathy after transplant is usually related to factors that occurred prior to transplant, such as a diagnosis of multiple myeloma or amyloidosis, rather than the transplant itself. 

Peripheral Neuropathy 

Certain types of chemotherapy, such as bortezomib (Velcade®), can cause peripherl neuropathy. Chemotherapy-induced neuropathy often smproves or completely resolves over time.

Long-term use of immune suppressants can also contribute to neuropathy.

Peripheral neuropathy can cause many different symptoms because it affects different types of nerve fibers. Symptoms may include:

  • pain
  • a burning sensation
  • numbness
  • loss of sensation
  • weakness
  • muscle wasting.

It's usually symmetric, meaning it's the same on the left and right sides of the body. As it progresses, patients may experience poor balance and weakness. 

Autonomic neuropathy affects nerves that control involuntary bodily functions such as:

  • blood pressure
  • heart rate regulation
  • bowel and bladder function
  • sexual function
  • vision 
  • sweat


If you are experiencing symptoms of neuropathy, consult a neurologist. The neurologist will conduct a thorough examination to determine what type of neuropathy you are experiencing so that it can be properly treated.

Prescription medications that can help with peripheral neuropathy include:

  • duloxetine (Cymbalta®)
  •  gabapentin (Neurontin®)
  • amitriptyline
  • pregabalin (Lyrica®). 

A number of over-the-counter agents can reduce neuropathy pain such as:

  • Biofreeze®
  • Capsaicin
  • Cannabidiol (CBD)

Exercise can significantly relieve the symptoms of neuropathy for many patients. Massage, physical therapy acupuncture and may also provide relief.

Treatment for autonomic neuropathy varies, depending on the symptoms. 


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Next Page: Late Effects on Organs and Tissues

Updated June 2024