Transplanted (solid) organ frequency: kidney > liver > heart > lung > pancreas > other (combined and intestines)
Most transplant-related emergencies due to one of the following:
Infection
Medication side effect
Graft-versus-host disease
Postoperative complications
Altered physiology due to transplanted organ
Infection
Medication side effect
Graft-versus-host disease
Postoperative complications
Altered physiology due to transplanted organ
Types of presentations
Infection (39%)
Noninfectious GI/GU pathology (15%)
Dehydration (15%)
Electrolyte disturbances (10%)
Cardiopulmonary pathology (10%)
Injury (8%)
Rejection (6%)
Acute graft-versus-host disease occurs in 20% to 80% of patients post-hematopoietic stem cell transplantation (HSCT); rarely occurs in solid organ transplant 
Infection (39%)
Noninfectious GI/GU pathology (15%)
Dehydration (15%)
Electrolyte disturbances (10%)
Cardiopulmonary pathology (10%)
Injury (8%)
Rejection (6%)
Balance between immune suppression, rejection and susceptibility to infection
Typical regimen includes: calcineurin inhibitor + antimetabolite + steroid
Calcineurin inhibitor
Cyclosporine
Tacrolimus
Steroids
Prednisone/Prednisolone
+/- Antimetabolite
Azathioprine
Mycophenolate mofetil (MMF)
Calcineurin inhibitor
Cyclosporine
Tacrolimus
Steroids
Prednisone/Prednisolone
+/- Antimetabolite
Azathioprine
Mycophenolate mofetil (MMF)
Cyclosporine
Tacrolimus
Prednisone/Prednisolone
Azathioprine
Mycophenolate mofetil (MMF)
Time from transplantation affects the risk and type of infection.
Early (within the first month)
Donor-derived - bacterial, fungal, parasitic
Nosocomial & surgical-site - C. diff, aspiration Pneumonia, UTI, surgical-site, superinfection of graft tissue
Intermediate (1-6 months after)
Highest risk for opportunistic infections - PCP, TB, fungal (cryptococcus, histoplasma), viral (BK virus, hepatitis B/C, CMV)
Dormant host infection reactivation - HSV, VZV, EBV
Late (more than 6 months after)
Community-acquired infection
Donor-derived - bacterial, fungal, parasitic
Nosocomial & surgical-site - C. diff, aspiration Pneumonia, UTI, surgical-site, superinfection of graft tissue
Highest risk for opportunistic infections - PCP, TB, fungal (cryptococcus, histoplasma), viral (BK virus, hepatitis B/C, CMV)
Dormant host infection reactivation - HSV, VZV, EBV
Community-acquired infection
Transplant complications
Liver transplant complications
Kidney transplant complications
Transfusion infections
Pancreas transplant complications
Stem cell transplant complications
Heart transplant complications
Lung transplant complications