Difference between revisions of "Transplant complications"

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Revision as of 06:55, 4 August 2015

Background

  • Transplanted organ frequency: kidney > liver > heart > lung > pancreas > other (combined and intestines)
  • 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

Clinical Features

Differential Diagnosis

Diagnosis

Management

Disposition

See Also

External Links

References

  1. Tintinalli's
  2. Tintinalli's