Anest. intenziv. Med. 2018;29(6):328-337

Specifics of anaesthesia and intensive care in organ transplant patientsCelková anestezie - přehledový článek

E. Kieslichová^*, E. Uchytilová, P. Píza, P. Vychodil

Klinika anesteziologie, resuscitace a intenzivní péče, Transplantcentrum, Institut klinické a experimentální medicíny

Solid organ transplantation is the only way to treat end-stage organ disease. Survival of the patients with a transplanted organ has improved significantly in the last decades. It has been mainly due to the careful selection of organ transplant candidates from the waiting lists, improved surgical techniques and advances in intensive care and immunosuppressive therapy. This has logically led to an increase in the number of these patients on the follow-up, treated in the emergency departments and admitted to hospitals and intensive care units. The anaesthetic and intensive care management of the transplant recipients is similar to standard practice but there are physiological and pharmacological specific aspects including the adverse effects of immunosuppression, the risk of infection and the risk of rejection which the anaesthetist and the intensivist should consider. One of the most common reasons for hospital admission of the transplanted patients is infection and sepsis, the most common cause of morbidity and mortality in these patients. The cornerstones in the treatment of sepsis are early pathogen identification, infection source control and supportive therapy including temporary withdrawal of the immunosuppressive therapy.

Keywords: solid organ transplantation; immunosuppressive therapy; anaesthesia and intensive care; sepsis

Received: September 27, 2018; Accepted: November 1, 2018; Published: December 1, 2018  Show citation