[Intensive Care Treatment Following Transplant Surgery]

Overview

Journal Chirurg

Specialty General Surgery

Date 2006 Jul 6

PMID 16821050

Authors

S Kohler

A Pascher

P Neuhaus

Affiliations

Soon will be listed here.

Abstract

Transplant-related intensive care treatment after transplantation of visceral organs, in Germany traditionally headed by transplant surgeons, is an integral part of postoperative therapy after liver, pancreas, intestinal, and combined organ transplantation, i.e. pancreas-kidney, liver-kidney, and multivisceral transplantation. Apart from adjustment and monitoring of immunosuppressive therapy, as well as common intensive care issues such as cardiopulmonary disease and complications, the avoidance, early detection, and rigorous treatment of transplant-related problems are the focus of surgical intensive care treatment of transplant patients. In the following article, its role after visceral organ transplantation is described regarding the most frequent transplant-related complications such as technical failure, various kinds of infection, and graft failure with different etiologies.

References

Abu-Elmagd K, Reyes J, Bond G, Mazariegos G, Wu T, Murase N . Clinical intestinal transplantation: a decade of experience at a single center. Ann Surg. 2001; 234(3):404-16; discussion 416-7. PMC: 1422031. DOI: 10.1097/00000658-200109000-00014. View

Razonable R, Paya C . Herpesvirus infections in transplant recipients: current challenges in the clinical management of cytomegalovirus and Epstein-Barr virus infections. Herpes. 2004; 10(3):60-5. View

Winston D, Emmanouilides C, Busuttil R . Infections in liver transplant recipients. Clin Infect Dis. 1995; 21(5):1077-89; quiz 1090-1. DOI: 10.1093/clinids/21.5.1077. View

Reinke P, Fietze E, Prosch S, Lippert J, Ewert R, Volk H . Late-acute renal allograft rejection and symptomless cytomegalovirus infection. Lancet. 1994; 344(8939-8940):1737-8. DOI: 10.1016/s0140-6736(94)92887-8. View

Sobhonslidsuk A, Reddy K . Portal vein thrombosis: a concise review. Am J Gastroenterol. 2002; 97(3):535-41. DOI: 10.1111/j.1572-0241.2002.05527.x. View

Gruessner R, Sutherland D, Gruessner A . Survival after pancreas transplantation. JAMA. 2005; 293(6):675. DOI: 10.1001/jama.293.6.675-a. View

Pascher A, Radke C, Dignass A, Schulz R, Veltzke-Schlieker W, Adler A . Successful infliximab treatment of steroid and OKT3 refractory acute cellular rejection in two patients after intestinal transplantation. Transplantation. 2003; 76(3):615-8. DOI: 10.1097/01.TP.0000072804.41125.82. View

Uflacker R, Selby J, Chavin K, Rogers J, Baliga P . Transcatheter splenic artery occlusion for treatment of splenic artery steal syndrome after orthotopic liver transplantation. Cardiovasc Intervent Radiol. 2002; 25(4):300-6. DOI: 10.1007/s00270-002-2614-5. View

Paramesh A, Roayaie S, Doan Y, Schwartz M, Emre S, Fishbein T . Post-liver transplant acute renal failure: factors predicting development of end-stage renal disease. Clin Transplant. 2004; 18(1):94-9. DOI: 10.1046/j.1399-0012.2003.00132.x. View

10.

Mazariegos G, Molmenti E, Kramer D . Early complications after orthotopic liver transplantation. Surg Clin North Am. 1999; 79(1):109-29. DOI: 10.1016/s0039-6109(05)70009-8. View

11.

Blair J, Kusne S . Bacterial, mycobacterial, and protozoal infections after liver transplantation--part I. Liver Transpl. 2005; 11(12):1452-9. DOI: 10.1002/lt.20624. View

12.

Boggi U, Vistoli F, Signori S, Del Chiaro M, Campatelli A, Di Candio G . Surveillance and rescue of pancreas grafts. Transplant Proc. 2005; 37(6):2644-7. DOI: 10.1016/j.transproceed.2005.06.085. View

13.

Pascher A, Neuhaus P . Bile duct complications after liver transplantation. Transpl Int. 2005; 18(6):627-42. DOI: 10.1111/j.1432-2277.2005.00123.x. View

14.

Jain A, Costa G, Marsh W, Fontes P, deVera M, Mazariegos G . Thrombotic and nonthrombotic hepatic artery complications in adults and children following primary liver transplantation with long-term follow-up in 1000 consecutive patients. Transpl Int. 2005; 19(1):27-37. DOI: 10.1111/j.1432-2277.2005.00224.x. View

15.

Bahra M, Neumann U, Jacob D, Langrehr J, Neuhaus P . Repeated steroid pulse therapies in HCV-positive liver recipients: significant risk factor for HCV-related graft loss. Transplant Proc. 2005; 37(4):1700-2. DOI: 10.1016/j.transproceed.2005.03.081. View

16.

Zaman F, Abreo K, Levine S, Maley W, Zibari G . Pancreatic transplantation: evaluation and management. J Intensive Care Med. 2004; 19(3):127-39. DOI: 10.1177/0885066604263916. View

17.

McGilvray I, Greig P . Critical care of the liver transplant patient: an update. Curr Opin Crit Care. 2002; 8(2):178-82. DOI: 10.1097/00075198-200204000-00015. View

18.

Shimoda M, Saab S, Morrisey M, Ghobrial R, Farmer D, Chen P . A cost-effectiveness analysis of biliary anastomosis with or without T-tube after orthotopic liver transplantation. Am J Transplant. 2002; 1(2):157-61. View

19.

Finn L, Reyes J, Bueno J, Yunis E . Epstein-Barr virus infections in children after transplantation of the small intestine. Am J Surg Pathol. 1998; 22(3):299-309. DOI: 10.1097/00000478-199803000-00004. View

20.

Akhlaghi F, Trull A . Distribution of cyclosporin in organ transplant recipients. Clin Pharmacokinet. 2002; 41(9):615-37. DOI: 10.2165/00003088-200241090-00001. View