Transplant complications: Difference between revisions
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***Azathioprine | ***Azathioprine | ||
***Mycophenolate Mofetil (MMF) | ***Mycophenolate Mofetil (MMF) | ||
** | **[[Steroids]] | ||
***Prednisone/Prednisolone | ***[[Prednisone]]/[[Prednisolone]] | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 22:17, 9 September 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)
- Steroids
- Calcineurin inhibitor