Approach to the transplanted patient in acute care: a comprehensive update

Organ transplant patients present to emergency departments (EDs) for conditions often associated with transplantation due to changing anatomy, denervated allograft and immunosuppression. Infections and rejection are among the most feared problems in these patients. It is necessary to maintain a high index of suspicion. The process should be carried out in a multidisciplinary fashion with the transplantation team including specialists in infectious diseases. When evaluating these patients, conditions that are easily managed in other patients should be carefully investigated. Emergency care providers should recognize infections and other complications, obtain diagnostic work up, initiate empirical treatment and consider specialty consultation and inpatient admission. Even if these patients are referred to hospitals for reasons unrelated to transplantation, healthcare providers need to know their differences, the expected effects of the drugs to be administered, and to be aware of probable drug interactions while their treatment is being planned.

Transplantation; Lung; Kidney; Infection; Immunosuppression; Heart; Liver; Rejection; Solid organ transplantation

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