II. Complications: Infection

  1. T Cells function poorly after transplant for the first 100 days
    1. Higher risk of Viral Infection during this time
  2. Infections otherwise follow a pattern based on time from transplant that is similar to Solid Organ Transplant
    1. Month 1: Nosocomial infection (e.g. CAUTI, VAP, SSI)
    2. Month 1-6: Opportunistic infection (CMV, EBV, fungal and Parasitic Infections, Tuberculosis)
    3. Month 6+: Community acquired infection (e.g. Pneumonia) and opportunistic infections

III. Complications: Allogenic - Early (first year)

  1. Graft-versus host (severe active, higher risk)
  2. Chronic Diarrhea, malabsorption and Electrolyte abnormalities
  3. Hemorrhagic cystitis
    1. Risk of Acute Renal Failure
    2. Initiate IV fluids
    3. Obtain renal Ultrasound

IV. Complications: Allogenic - Late (10 years post transplant)

  1. Graft-versus-host (chronic, residual)
  2. HPV-mediated oropharyngeal cancer
  3. Lung disease
  4. Growth Hormone Deficiency with Short Stature
  5. Hypogonadism
  6. Hypothyroidism
  7. Basal Cell Carcinoma
  8. Cirrhosis

V. References

  1. Bhatia and Claudius in Herbert (2013) EM:Rap 13(6): 6-7
  2. Claudius, Ruttan and DeFabio in Swadron (2022) EM:Rap 22(11): 13
  3. Bhatia (2012) Pediatrics 130(6): 1141-3 [PubMed]

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