Early Medical Problems Common To Many Recipients

Complications following organ transplantation can be categorized as early or late, depending upon whether they occur within six months or later in the posttransplantation period. However, some of these complications can overlap in their time of occurrence. Posttransplantation complications can also be divided into organ specific complications, and those common to all transplantation procedures. Global complications following transplant are often related to the immunosuppressive drugs used to control allograft rejection, and include hypertension, cardiovascular disease, hyperlipidemia, infection, drug-induced neph-rotoxicity, metabolic bone disorders, and malignancy. The reader is referred to Chapters 2,16 and Appendix 1 (in this text) for a review of immunosuppressive drugs and their long-term effects.

Many problems in the early posttransplant period are related to the surgical procedure itself (mechanical), while others are strictly medical problems. These early complications are best managed at a transplantation center to avoid the consequences of misdiagnosis and inadequate evaluation. Table 17.1 summarizes the early complications associated with different forms of organ transplants. The reader is referred to appropriate chapters in this text for more detailed discussion of many of the organ-specific mechanical complications, as well as for a comprehensive review of posttransplant infections. The remainder of this Chapter will focus on problems encountered in patients undergoing renal, pancreatic, and hepatic transplantation.

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