RT Book, Section
A1 Scales, Damon C.
A1 Granton, John T.
A2 Hall, Jesse B.
A2 Schmidt, Gregory A.
A2 Wood, Lawrence D.H.
SR Print(0)
ID 2297315
T1 Chapter 90. The Transplant Patient
T2 Principles of Critical Care, 3e
YR 2005
FD 2005
PB The McGraw-Hill Companies
PP New York, NY
SN 9780071416405
LK accessanesthesiology.mhmedical.com/content.aspx?aid=2297315
RD 2020/09/23
AB The  critical  care  of  the  transplant  recipient  requires  a  multidisciplinary  approach.Although  some  generalizations  can  be  made  regarding  the  management  of  all  transplant  patients,  organ-specific  considerations  based  on  the  particular  allograft  transplanted  are  often  much  more  important.Risks  and  benefits  of  immunosuppressive  therapy  must  be  balanced  in  transplant  recipients.  Though  immunosuppressive  drugs  are  essential  to  prevent  allograft  rejection,  they  also  increase  the  risk  of  infection  and  neoplasm.All  immunosuppressive  drugs  have  side  effects  and  many  have  important  drug-drug  interactions  that  must  be  recognized  by  the  intensivist.Rejection  of  the  allograft  can  be  divided  into  three  broad  categories:  hyperacute,  acute,  and  chronic  rejection.Infections  can  reactivate  in  an  immunocompromised  recipient  who  has  been  previously  exposed.  Alternatively,  a  naïve  recipient  may  acquire  an  infection  following  the  transplant  of  an  organ  from  a  seropositive  donor.Infections  in  transplant  recipients  can  progress  rapidly  and  hence  must  be  promptly  recognized  and  appropriately  treated.Often  immunosuppressive  therapy  must  be  adjusted  or  withdrawn  in  the  presence  of  severe  infection.