Care of the organ transplant recipient

Organ and tissue allografting is now a commonly performed procedure. Patients receiving allografts and immunosuppressive medication are no longer restricted to a few specialized centers and areas of the country. Because transplant recipients are leading longer and healthier lives, these patients are appearing in diverse medical settings where expertise in transplantation is not generally established. Because many generalist and specialist physicians can expect to treat this group of patients, it is important that information about the care of transplant patients and their particular problems and needs be made more accessible to other physicians.

The authors have compiled the most numerous questions and problems from referring physicians, emergency department physicians, and housestaff and have reviewed the recent literature pertinent to particular issues.

This review addresses some of the common problems and myths that surround transplant recipients and discusses how best to initiate care for these patients, particularly when they seek treatment from a nontransplant physician. This review is not exhaustive, but rather a field guide to the initial care of this group of patients. The notion that only those with specialized knowledge can care for these individuals must now be relinquished so that these patients can enter the mainstream of medical care.