Transplant - Organ transplant complications

4 important questions on Transplant - Organ transplant complications

Infection symptoms to self-monitor for

-fever of 100.4 F +
-cough, more sputum or change in sputum color, sore throat
-pain with passing urine, ear or sinus pain
-mouth sores and wound that does not heal

Initial approach to treat acute cellular rejection (ACR)

Admin of high-dose steroids and optimize maintenance immunosuppression [antithymocyte globulin is usually saved for steroid-resistant or more aggressive ACR]

When is infection prophylaxis essential?

First 6 mo post-transplant (when immunosuppression is highest) and after receiving treatment for acute rejection
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Important vaccines for transplant recipients

-Inactivated flu annually
-Pneumococcal in adults 19+
   -PCV20 (prevnar) x1
     OR
   -PCV15 (vaxneuvance) x1 -> 8 weeks -> PPSV23 (pneumovax)
-Varicella (pre-transplant)
-Hep B (pre-transplant and post if indicated)

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