Publication: Fiebre e infección en el paciente trasplantado de órgano sólido: recomendaciones clínicas en diferentes contextos
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2017-09-05
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Universidad Complutense de Madrid
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Abstract
Introducción El trasplante es un procedimiento coste-eficaz que supone la salvación la vida de miles de pacientes, y que mejora claramente su calidad de vida. A lo largo de la historia, ha habido que realizar miles de intentos fallidos hasta el año 1954 cuando tiene lugar el primer trasplante renal con éxito total entre dos pacientes gemelos univitelinos en la Universidad de Harvard de Boston. Desde entonces hasta nuestros días se han producido grandes avances en la técnica quirúrgica y el manejo posterior de los pacientes con trasplante de órgano sólido. Actualmente, España se sitúa como líder mundial tanto de donación de órganos como en trasplantes realizados. Durante el proceso de donación-trasplante, el médico especialista continúa enfrentándose a diferentes retos y nuevas dificultades en el manejo del paciente con trasplante. Durante el periodo previo a la cirugía, se requieren potenciar una correcta relación médico-paciente, establecer un buen programa educacional y completar un régimen de visitas ambulatorias para el cribado diagnóstico. Posteriormente al trasplante los principales condicionantes en el pronóstico del paciente con TOS son los episodios de infección y el rechazo del órgano...
Introduction Transplantation is a cost-effective procedure which is saving the lives of thousands of patients, and clearly improves their quality of life. Throughout history, thousands of failed attempts have been performed until 1954, when the first kidney transplant was carried out with success among monozygotic twin patients at Harvard University in Boston. From then until now, there have been great advances in surgical technique and subsequent management of patients with solid organ transplantation (SOT). Currently, Spain is world leader in both organ donation and transplant surgery. During the process, medical specialist continues facing difficulties and new challenges in the management of SOT recipients. Before transplant surgery, setting a suitable doctor-patient relationship, establishing a good educational program and complete a system of outpatient visits for diagnostic screening are required. During post-transplant period, main determinants of SOT are infection episodes and graft rejection. Infectious episodes are major complication associated with transplant procedure, and are one of the main causes of mortality in these patients. Special immunosuppressant situation, especially in the earlier surgery period is an added risk factor for acquisition. Furthermore, fever as an alarming sign, represents the mail challenge for clinicians in diagnosis approach. At this point, persistent fever involves a thorough workup to establish the etiology of fever of unknown origin (FOD) in this group of patients...
Introduction Transplantation is a cost-effective procedure which is saving the lives of thousands of patients, and clearly improves their quality of life. Throughout history, thousands of failed attempts have been performed until 1954, when the first kidney transplant was carried out with success among monozygotic twin patients at Harvard University in Boston. From then until now, there have been great advances in surgical technique and subsequent management of patients with solid organ transplantation (SOT). Currently, Spain is world leader in both organ donation and transplant surgery. During the process, medical specialist continues facing difficulties and new challenges in the management of SOT recipients. Before transplant surgery, setting a suitable doctor-patient relationship, establishing a good educational program and complete a system of outpatient visits for diagnostic screening are required. During post-transplant period, main determinants of SOT are infection episodes and graft rejection. Infectious episodes are major complication associated with transplant procedure, and are one of the main causes of mortality in these patients. Special immunosuppressant situation, especially in the earlier surgery period is an added risk factor for acquisition. Furthermore, fever as an alarming sign, represents the mail challenge for clinicians in diagnosis approach. At this point, persistent fever involves a thorough workup to establish the etiology of fever of unknown origin (FOD) in this group of patients...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 16-09-2016