title: Sepsis in Solid-Organ Transplant Patients.
abstract: The growing population of solid organ transplant (SOT) recipients is at a significantly increased risk for developing infections. In some patients, the infection can lead to a dysregulated systemic inflammatory response with acute organ dysfunction. SOT recipients with sepsis tend to have less fever and leukocytosis instances. Moreover, they have diminished symptoms and attenuated clinical and radiologic findings. The current management of sepsis is similar to general patients. It relies mainly on early recognition and treatment, including appropriate administration of antibiotics and resuscitation with intravenous fluids and vasoactive drugs when needed. The infusion of fluids should be closely monitored because elevated central venous pressure levels and fluid overload can be particularly harmful. There is no consensus on how to manage immunosuppressive therapies during sepsis, although dose reduction or withdrawal is suggested to improve the host immunological response. There is compelling evidence suggesting that infections are associated with reduced allograft and patient survival. However, the traditional belief that SOT patients who develop sepsis have worse outcomes than non-transplanted patients has been challenged.
authors.affiliation: *Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo-UNIFESP, São Paulo, SP, Brazil †Nephrology Division, Hospital do Rim e Hipertensão, Federal University of São Paulo-UNIFESP, São Paulo, SP, Brazil.
authors.forename: Antônio Tonete
authors.initials: AT
authors.lastname: Bafi
authors.forename: Daniere Yurie Vieira
authors.initials: DY
authors.lastname: Tomotani
authors.forename: Flávio Geraldo Rezende
authors.initials: FG
authors.lastname: de Freitas
mesh_terms: D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D016377:Organ Transplantation / Q000706:statistics & numerical data*; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology*; D012772:Shock, Septic / Q000188:drug therapy / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents