2025 Multiprofessional Critical Care Review: Adult Online-Complications of Solid Organ Transplantation

Video Transcription

Video Summary

This talk focuses on complications after solid organ transplantation, primarily liver and kidney. Key issues include infection, graft dysfunction, rejection, malignancy risk, and drug toxicities from immunosuppressants like Tacrolimus, MMF, and steroids. Post-transplant infections vary over time: early infections are often nosocomial, while later stages see increased viral and opportunistic infections. Malignancy risk rises two to fourfold, with skin cancers and PTLD being notable concerns. Acute rejection is common early on, diagnosed via biopsy, and treated with steroids or plasmapheresis. Liver transplant complications include vascular thrombosis and biliary issues often detected by Doppler ultrasound. Kidney transplant complications involve vascular stenosis, rejection types—acute cellular and antibody-mediated—and delayed graft function. The liver’s unique immunology means antibody-mediated rejection is rare. Overall, timelines guide differential diagnosis, and close monitoring, including imaging and viral testing, is crucial for managing transplant patients effectively.

Keywords

solid organ transplantation

infection post-transplant

graft rejection

immunosuppressant toxicities

post-transplant malignancy

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