Difference between revisions of "Transplant complications"

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**Rejection (6%)
 
**Rejection (6%)
 
*Acute graft-versus-host disease occurs in 20% to 80% of patients post-hematopoietic stem cell transplantation (HSCT); rarely occurs in solid organ transplant <ref>Tintinalli's</ref>
 
*Acute graft-versus-host disease occurs in 20% to 80% of patients post-hematopoietic stem cell transplantation (HSCT); rarely occurs in solid organ transplant <ref>Tintinalli's</ref>
 +
 +
==Complications Due to Immunosuppressant Medications==
 +
*Balance between immune suppression, rejection and susceptibility to infection
 +
*Typical regimen includes: calcineurin inhibitor + antimetabolite + steroid
 +
**Calcineurin inhibitor
 +
***Cyclosporine
 +
***Tacrolimus
 +
**Antimetabolite
 +
***Azathioprine
 +
***Mycophenolate Mofetil (MMF)
 +
**Steroid
 +
***Prednisone/Prednisolone
 +
 +
  
 
<references/>
 
<references/>

Revision as of 20:32, 21 June 2015

Background

  • Transplanted organ frequency: kidney > liver > heart > lung > pancreas > other (combined and intestines)
    • First solid organ transplant was in 1954 (kidney)
  • Most transplant patients require lifelong immunosuppression
  • Types of emergencies
    • transplant-related infection
    • medication side effects
    • rejection
    • graft-versus-host disease
    • postoperative complications and complications of altered physiology secondary to the transplanted organ
  • Often transplant patients present with common medical problems but require unique management due to their altered physiology [1]

Epidemiology

  • Types of presentations
    • Infection (39%)
    • Noninfectious GI/GU pathology (15%)
    • Dehydration (15%)
    • Electrolyte disturbances (10%)
    • Cardiopulmonary pathology (10%)
    • Injury (8%)
    • Rejection (6%)
  • Acute graft-versus-host disease occurs in 20% to 80% of patients post-hematopoietic stem cell transplantation (HSCT); rarely occurs in solid organ transplant [2]

Complications Due to Immunosuppressant Medications

  • Balance between immune suppression, rejection and susceptibility to infection
  • Typical regimen includes: calcineurin inhibitor + antimetabolite + steroid
    • Calcineurin inhibitor
      • Cyclosporine
      • Tacrolimus
    • Antimetabolite
      • Azathioprine
      • Mycophenolate Mofetil (MMF)
    • Steroid
      • Prednisone/Prednisolone


  1. Tintinalli's
  2. Tintinalli's