Transplant Emergencies
Transplanted organs don't act like normal organs, won't hurt and are in weird locales - Jessica Goldonowicz MD
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Transplant Emergencies - Dr. Goldonowicz
Rejection
- Hyperacute - w/in minutes - we won't see
- Acute
- Chronic
Anatomy
- Vascular - stenosis, aneurysm, thrombosis
- Nonvascular - leak, scar formation, dislodged stint, stone formation
Infection
- First 28 days - nosocomial
- 1-6 months - viral infections - CMV, hepatitis, EBV, HH6; oppurtunisitcs - PCP, listeria, fungal
- > 6 months - Healthy - UTI, PNA, cold, Chronic viral infection - EBV, zoster, HSV
Drug Toxicity
- Transplant immunosuppressants - cyclosprine,…
Resources
Transplant Emergencies Part I: Infection, Rejection, and Medication Effects
These patients can be challenging to manage, as they are on immunosuppressive medications and have significant anatomic and physiologic variations.3-5 Transplant patients may develop a significant number of complications including infection, medication effects, rejection, and specific complications related to the transplanted organ.
Transplant Emergencies Part II: Organ Specific Complications
This is part II of a series detailing transplant emergencies. Part I covered transplant infection, rejection and medication side effects. We will evaluate renal, cardiac, liver, and lung transplant complications in this post.
Transplant Medicine in the ED
This review summarizes the physiology of transplant and a few of the key issues to be aware of in these patients.
Fear of Rejection: Managing the Transplant Patient in the ED
These patients can be challenging to manage, as they are on immunosuppressive medications and have significant anatomic and physiologic variations
Management of Pediatric Transplant Patients in the Emergency Department
This review discusses the general approach to the management of pediatric transplant patients in the emergency department, with a focus on general complications and organ-specific complications after solid organ transplantation. Hematopoietic stem cell transplantation and its common complications will also be discussed.
Managing renal transplant complications
Rejection is the only unique cause for renal failure in kidney transplant patients. Two common causes of acute renal failure are acute cyclosporine or tacrolimus nephrotoxicity and acute rejection.
Transplant Emergencies and Their Management
Fever can be a sign of rejection, NOT always infection (Biopsy is typically needed).
Transplant “emergencies” AKA It's 3 a.m., why are you calling ...
The reasons why you will get called about transplant patients aren’t necessarily the same as the reasons why patients are evaluated in the ED.
Transplant Emergencies - Dr. Goldonowicz
Transplanted organs don't act like normal organs, won't hurt and are in weird locales...
Rush Emergency Medicine
Working in the ED of a hospital that performs transplants means that you see a lot of people that are pre-, post-, post-and-pre-again-transplant. We are very very lucky that the transplant teams at Rush are very involved and involved early. In fact we are so lucky that transplant surgeon Dr. Edie Chan, came and give us a talk. This post is in summary of some of the wisdom she imparted on us: focusing specifically on liver and kidney transplants.
WikEM
Most transplant-related emergencies due to one of the following: Infection, Medication side effect, Graft-versus-host disease, Postoperative complications, Altered physiology due to transplanted organ.
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