Sirolimus slows down wound healing. Consider switching transplant patients to a different immunosupressive drug to limit wound healing problems.
Patients on Sirolimus also exhibit higher post operative complications of seromas, hernias, and wound dehiscence.
We have gotten away from the practice of administering stress dose steroids on most general surgery patients on maintenance steroids
Avoid placing hemodialysis catheters if possible because of the short-term and long-term complications.
Most likely wouldn’t remove a catheter just for a febrile episode on hemodialysis. But if the patient is septic – still try to maintain the catheter if possible.
UNOS = united network of organ sharing. When an organ donor is identified, the info is sent to UNOS who then generate a list of possible recipients.
Travel outside of the US. Big question is who is the donor?
Organ trafficking is illegal in the US. But not illegal to take care of the patient postop in the US after the patient had gone overseas.
AV fistulas are considered to be better than AV grafts – short-term and long term.
Peritoneal Dialysis use is expanding – many people who weren’t considered eligible in the past are now eligible.
Immunosuppression increases the risk for cancer.
Typhlitis, non-surgical protocol is used whenever possible when the patient is not toxic. Typhlon = cecum (Greek). Necrotizing enterocolitis, neutropenic enterocolitis., caecitis. Typhlitis affects immunocompromized patients such as those undergoing chemotherapy, patients with AIDS, transplant patients, or the elderly.