Perspective

As greater numbers of people enjoy long-term success after organ transplantation, the need to properly manage nontransplant surgical disease has become increasingly apparent. Similar to the experience with transplantation itself, important insight into optimal management strategies have evolved over the past ten to fifteen years. The underlying principles of surgery remain applicable, and specific approaches are frequently identical to those for the general population. However, there are also important differences in management of some specific problems, and there are always important management peculiarities that result from the immunosuppressed state. Immunosuppressed transplant recipients live in a precarious homeostatic balance with unquestionably less reserve margin when compared to the general population. However, careful attention to detail and collaborative care including appropriate surgical specialists and the transplant team, have been demonstrated to afford excellent outcomes for this challenging group of surgical patients.

References

1. Bromberg JS, Baliga P, Cofer. Stress steroids are not required for patients receiving a renal allograft and undergoing operation. J Amer Coll Surg 1995; 180 (5):532-6.

2. Dodd DA. Rapid resolution of gingival hyperplasia after switching from cyclosporine A to tacrolimus [letter]. J Heart & Lung Transpl 1997; 16(5):579.

3. Lorber MI, Basadonna GP, Friedman AL. Pathophysiology and treatment of gallstone disease in organ transplant recipients. J Neph 1996; 9(5):225-231.

4. Bornstein J. Rahat MA. Abramovici H. Etiology of cervical cancer: Current concepts. Obstetr Gynecol Surv 1995; 50(2):146-54.

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