Primary care of the transplant patient.
A total of 153,245 patients are living with a solid organ transplant in the US. In addition, patients are experiencing high 5-year survival rates after transplantation. Thus, primary care physicians will be caring for transplanted patients. The aim of this review is to update primary care physicians on chronic diseases, screening for malignancy, immunizations, and contraception in the transplant patient. Several studies on the treatment of hypertension and hyperlipidemia demonstrate that most agents used to treat the general population also can be used to treat transplant recipients. Little information exists on the medical management of diabetes in the transplant population, but experts in the area believe that the treatment of diabetes should be similar. Transplant recipients are at increased risk for all malignancies. Aggressive screening should be employed for all cancers with a proven screening benefit. Killed immunizations are safe for the transplant population, but live virus vaccines should be avoided. Women of childbearing age should be counseled about the impact of immunosuppressants on the efficacy and side effects of contraception.
Hasley
Peggy B
PB
University of Pittsburgh School of Medicine, PA 15213, USA. hasleypb@upmc.edu
Arnold
Robert M
RM
D006801:Humans; D007388:Internal Medicine / Q000379:methods*; D016377:Organ Transplantation; D011320:Primary Health Care / Q000379:methods*; D014481:United States