Sepsis in Solid-Organ Transplant Patients

Sepsis in Solid-Organ Transplant Patients

Author Bafi, Antonio Tonete Autor UNIFESP Google Scholar
Tomotani, Daniere Yurie Vieira Autor UNIFESP Google Scholar
Freitas, Flavio Geraldo Rezende Autor UNIFESP Google Scholar
Abstract The growing population of solid organ transplant (SOT) recipients is at a significantly increased risk for developing infections. In some patients, the infection can lead to a dysregulated systemic inflammatory response with acute organ dysfunction. SOT recipients with sepsis tend to have less fever and leukocytosis instances. Moreover, they have diminished symptoms and attenuated clinical and radiologic findings. The current management of sepsis is similar to general patients. It relies mainly on early recognition and treatment, including appropriate administration of antibiotics and resuscitation with intravenous fluids and vasoactive drugs when needed. The infusion of fluids should be closely monitored because elevated central venous pressure levels and fluid overload can be particularly harmful. There is no consensus on how to manage immunosuppressive therapies during sepsis, although dose reduction or withdrawal is suggested to improve the host immunological response. There is compelling evidence suggesting that infections are associated with reduced allograft and patient survival. However, the traditional belief that SOT patients who develop sepsis have worse outcomes than non-transplanted patients has been challenged.
Keywords Immunosuppression
infection
multiple organ failure
organ transplantation
sepsis
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2017
Published in Shock. Philadelphia, v. 47, n. 1, p. 12-16, 2017.
ISSN 1073-2322 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 12-16
Origin http://dx.doi.org/10.1097/SHK.0000000000000700
Access rights Closed access
Type Article
Web of Science ID WOS:000401275900004
URI https://repositorio.unifesp.br/handle/11600/56306

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