Transplant complications: Difference between revisions
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*Often transplant patients present with common medical problems but require unique management due to their altered physiology <ref>Tintinalli's</ref> | *Often transplant patients present with common medical problems but require unique management due to their altered physiology <ref>Tintinalli's</ref> | ||
==Epidemiology== | ===Epidemiology=== | ||
*Types of presentations | *Types of presentations | ||
**Infection (39%) | **Infection (39%) | ||
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***Prednisone/Prednisolone | ***Prednisone/Prednisolone | ||
==Clinical Features== | |||
==Differential Diagnosis== | |||
==Diagnosis== | |||
==Management== | |||
==Disposition== | |||
==See Also== | |||
==External Links== | |||
==References== | |||
<references/> | <references/> |
Revision as of 01:43, 22 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
- Calcineurin inhibitor