Surgical Considerations in Solid-Organ Transplant Recipients

Advances in the management and the surgical techniques of solid-organ transplantation have led to a growing number of patients living longer with transplanted organs. Surgical intervention in these patients ideally should be carried out by the original transplant team; however, the goal of this review is to provide information for practicing surgeons who are not at a transplant center so that they may recognize transplant-related problems, to help decide when to perform an intervention or operation and when to consider transfer to a transplant center. With careful attention to medications and symptoms, general surgery principles will hold true with transplant patients. Minor procedures can usually be conducted without much modification, and major procedures may require some adjustment of the medication regimen. This review covers preoperative considerations, diagnostic and radiologic considerations, intraoperative considerations, management of perioperative infection, management of perioperative immunosuppression, postoperative management, when to consider transfer to a transplant center, special considerations, and annotated key references. Tables list anatomic and diagnostic deta