In this clinical case, the patient (a psychiatrist and one of the authors) experienced a variety of hyperacutemedical and neuro-psychiatric complications after kidney transplant rejection. The patient’s personal reflectionsand observations, communications with his wife, descriptions of clinical and experiential events, and medicalinterventions at different stages of the process are presented. Literature on the phenomenology of these complicationsand the bio-psycho-socio-cultural factors at play are reviewed. The unique perception of the psychiatrist’s ownexperience lends support to recommendations regarding roles of different discipline members of the transplantteam, and procedures for adequate clinical management of kidney transplant rejection.(Rev Neuropsiquiatr 2009;72:67-74).

Mild cognitive impairment (MCI) is a relatively newly described phenomenon representing a mild deficit on the continuum between normal aging and dementia. Although MCI is the source of much interest and research in the fields of neuroscience and medicine, its definition, prevalence, and criteria for diagnosis has yet to become standardized and is the subject of much controversy. While there is some consensus among American and European researchers about the construct of MCI, others argue that these researchers focus too much on MCI as a preclinical state of Alzheimer’s disease (Ad) and thus is too narrow. MCI must also be examined in the context of each individual patient, taking into account each person’s unique needs and the degree to which his or her life is affected by the cognitive impairment in question. As the upcoming DSM-5 criteria are still being decided, it is a particular...