Ver el código de «Kidney transplant complications»

==Background==
*most commonly transplanted organ

{{Transplant emergency types}}

{{Immunosuppressant medication complications}}

==Clinical Features==
The clinical features will depend on the type of complication and the amount of time elapsed post-transplantation.

===Hyperacute Rejection===
*Little or no urine output
*Widespread thrombosis

===Early Complications===
*Symptoms of infection 
*Symptoms of recurrent disease
*Decreased urine output
*Hemorrhagic or non-hemorrhagic cystitis 

===Late Acute===
*Symptoms of infection
*Symptoms of recurrent disease
*Decreased urine output
*Hemorrhagic or non-hemorrhagic cystitis 

===Late Chronic===
*Symptoms of infection
*Symptoms of recurrent disease
*Decreased urine output
*Hemorrhagic or non-hemorrhagic cystitis

===Infection===
*May not have classic findings due to immunosupression
*Presentation depends on source of infection

===Medication Adverse Effects===
*Prednisone
**Hyperglycemia, psychiatric symptoms, poor wound healing, edema, hypertension
*Tacrolimus, cyclosporine
**Neurotoxicity, tremor, hyperkalemia, nephrotoxicity, hypertension, hyperglycemia, gout
*Mycophenolate
**Cytopenias, GI distress
*Azathioprine
**Cytopenias, pancreatitis, hepatitis
 
==Differential Diagnosis==
*Solid organ rejection
*Infection
*Medication side effect
**[[Graft-versus-host disease]]
*Post-operative complications
*Diagnoses related to underlying disease or comorbidities

==Evaluation==
Depending on presentation, work-up may include:
*CBC
*BMP for BUN/creatinine 
**best prognostic marker of graft function
**necessary to dose some empiric antibiotics
*[[Urinalysis]] (for infection and signs of rejection)
*Tacrolimus/cyclosporine levels
*Infectious work-up
**Blood/urine cultures, PCR or other tests for viral/fungal infections as indicated
**[[CXR]]
*consider renal ultrasound for workup of rejection

==Management==
*Empiric antimicrobials for suspected infection
**See [[immunocompromised antibiotics]]
*Consult relevant transplant team
*High-dose steroids are usual therapy for rejection

==Disposition==

==See Also==
*[[Transplant complications]]
*[[Neutropenic fever]]
*[[Immunocompromised antibiotics]]

==External Links==

==References==
<references/>

[[Category:Renal]]
[[Category:Surgery]]