Skip to main content

Overview of Solid Organ Transplantation for Primary Care Providers

  • Chapter
  • First Online:
Primary Care of the Solid Organ Transplant Recipient

Abstract

Solid organ transplantation is increasing worldwide. The number of surviving solid organ transplant recipients exceeds the capacity of transplant centers to solely care for them. While a transplant specialist has a necessary role in the care of solid organ transplant recipients, primary care providers will need to be increasingly well-versed in their care as well. This chapter discusses the prevalence of solid organ transplantation, reviews the pre-transplant workup a solid organ transplant recipient is likely to have received, and provides a framework for the initial history-taking elements required for management of solid organ transplant recipients in the primary care setting.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Transplants in the U.S. by recipient age. U.S. transplants performed: January 1, 1988–March 31, 2019. Based on OPTN data as of April 21, 2019. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/. Accessed 22 Apr 2019.

  2. Hart A, Smith JM, Skeans MA, Gustafson SK, Wilk AR, Castro S, Robinson A, Wainright JL, Snyder JJ, Kasiske BL, Israni AK. OPTN/SRTR 2017 annual data report: kidney. Am J Transplant. 2019;19(Suppl 2):19–123. https://doi.org/10.1111/ajt.15274.

    Article  PubMed  Google Scholar 

  3. Kim WR, Lake JR, Smith JM, Schladt DP, Skeans MA, Noreen SM, Robinson AM, Miller E, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2017 annual data report: liver. Am J Transplant. 2019;19(Suppl 2):184–283. https://doi.org/10.1111/ajt.15276.

    Article  PubMed  Google Scholar 

  4. Colvin M, Smith JM, Hadley N, Skeans MA, Uccellini K, Lehman R, Robinson AM, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2017 annual data report: heart. Am J Transplant. 2019;19(Suppl 2):323–403. https://doi.org/10.1111/ajt.15278.

    Article  PubMed  Google Scholar 

  5. Valapour M, Lehr CJ, Skeans MA, Smith JM, Uccellini K, Lehman R, Robinson A, Israni AK, Snyder JJ, Kasiske BL. OPTN/SRTR 2017 annual data report: lung. Am J Transplant. 2019;19(Suppl 2):404–84. https://doi.org/10.1111/ajt.15279.

    Article  PubMed  Google Scholar 

  6. Global Observatory on Donation and Transplantation, World Health Organization. Organ Donation and Transplantation Activities 2016. Data as of September 2018, requested disclaimer as follows: “The data and information presented here are published in order to promote transparency in transplantation activities. Whenever possible this information has been confirmed by official national sources. However, in some instances, there are still provisional estimates. It is therefore anticipated that some data presented may be modified without prior notice.” Accessed 1 July 2019 at http://www.transplant-observatory.org/download/2016-activity-data-report/.

  7. White SL, Hirth R, Mahíllo B, Domínguez-Gil B, Delmonico FL, Noel L, Chapman J, Matesanz R, Carmona M, Alvarez M, Núñez JR, Leichtmang A. The global diffusion of organ transplantation: trends, drivers and policy implications. Bull World Health Organ. 2014;92:826–35. https://doi.org/10.2471/BLT.14.137653.

    Article  PubMed  PubMed Central  Google Scholar 

  8. UNOS Transplant Living. Frequently asked questions. Accessed 1 July 2019 at: https://transplantliving.org/before-the-transplant/frequently-asked-questions/.

  9. Katvan E, Doron I, Ashkenazi T, Boas H, Carmiel-Haggai M, Elhalel MD, Shnoor B, Lavee J. Age limitation for organ transplantation: the Israeli example. Age Ageing. 2017;46(1):8–10. https://doi.org/10.1093/ageing/afw162.

    Article  PubMed  Google Scholar 

  10. Vodkin I, Kuo A. Extended criteria donors in liver transplantation. Clin Liver Dis. 2017;21(2):289–301. https://doi.org/10.1016/j.cld.2016.12.004.

    Article  PubMed  Google Scholar 

  11. http://www.nationalkidneycenter.org/treatment-options/transplant/find-a-transplant-center/.

  12. Webb GJ, Hodson J, Chauhan A, O’Grady J, Neuberger JM, Hirschfield GM, Ferguson JW. Proximity to transplant center and outcome among liver transplant patients. Am J Transplant. 2019;19(1):208–20. https://doi.org/10.1111/ajt.15004.

    Article  PubMed  Google Scholar 

  13. Goldberg DS, French B, Forde KA, Groeneveld PW, Bittermann T, Backus L, Halpern SD, Kaplan DE. Association of distance from a transplant center with access to waitlist placement, receipt of liver transplantation, and survival among US veterans. JAMA. 2014;311(12):1234–43. https://doi.org/10.1001/jama.2014.2520.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Cicalese L, Shirafkan A, Jennings K, Zorzi D, Rastellini C. Increased risk of death for patients on the waitlist for liver transplant residing at greater distance from specialized liver transplant centers in the United States. Transplantation. 2016;100(10):2146–52. https://doi.org/10.1097/TP.0000000000001387.

    Article  PubMed  Google Scholar 

  15. Bunnapradist S, Danovitch GM. Evaluation of adult kidney transplant candidates. Am J Kidney Dis. 2007;50(5):890–8. https://doi.org/10.1053/j.ajkd.2007.08.010.

    Article  PubMed  Google Scholar 

  16. Weill D, Benden C, Corris PA, et al. A consensus document for the selection of lung transplant candidates: 2014--an update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2015;34(1):1–15. https://doi.org/10.1016/j.healun.2014.06.014.

    Article  PubMed  Google Scholar 

  17. Malinis M, Boucher HW, Practice ASTIDCo. Screening of donor and candidate prior to solid organ transplantation-guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transpl. 2019;33:e13548. https://doi.org/10.1111/ctr.13548.

    Article  Google Scholar 

  18. Martin P, DiMartini A, Feng S, Brown R Jr, Fallon M. Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation. Hepatology. 2014;59(3):1144–65. https://doi.org/10.1002/hep.26972.

    Article  PubMed  Google Scholar 

  19. Pham PT, Pham PA, Pham PC, Parikh S, Danovitch G. Evaluation of adult kidney transplant candidates. Semin Dial. 2010;23(6):595–605. https://doi.org/10.1111/j.1525-139X.2010.00809.x.

    Article  PubMed  Google Scholar 

  20. VanWagner LB, Harinstein ME, Runo JR, et al. Multidisciplinary approach to cardiac and pulmonary vascular disease risk assessment in liver transplantation: an evaluation of the evidence and consensus recommendations. Am J Transplant. 2018;18(1):30–42. https://doi.org/10.1111/ajt.14531.

    Article  PubMed  Google Scholar 

  21. Sandal S, Chen T, Cantarovich M. The challenges with the cardiac evaluation of liver and kidney transplant candidates. Transplantation. 2019;104:251. https://doi.org/10.1097/TP.0000000000002951.

    Article  Google Scholar 

  22. McAdams-DeMarco MA, Rasmussen S, Chu NM, et al. Perceptions and practices regarding frailty in kidney transplantation: results of a National Survey. Transplantation. 2019;104:349. https://doi.org/10.1097/TP.0000000000002779.

    Article  Google Scholar 

  23. Adegunsoye A, Strek ME, Garrity E, Guzy R, Bag R. Comprehensive care of the lung transplant patient. Chest. 2017;152(1):150–64. https://doi.org/10.1016/j.chest.2016.10.001.

    Article  PubMed  Google Scholar 

  24. Cimino FM, Snyder KA. Primary care of the solid organ transplant recipient. Am Fam Physician. 2016;93(3):203–10.

    PubMed  Google Scholar 

  25. Rubin LG, Levin MJ, Ljungman P, et al. IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):e44–100. https://doi.org/10.1093/cid/cit684.

    Article  PubMed  Google Scholar 

  26. Danziger-Isakov L, Kumar D. Vaccination of solid organ transplant candidates and recipients: guidelines from the American society of transplantation infectious diseases community of practice. Clin Transpl. 2019;33:e13563. https://doi.org/10.1111/ctr.13563.

    Article  Google Scholar 

  27. CDC. Pneumococcal vaccination: summary of who and when to vaccinate. Secondary pneumococcal vaccination: summary of who and when to vaccinate 2017. https://www.cdc.gov/vaccines/vpd/pneumo/hcp/who-when-to-vaccinate.html.

  28. Buchan CA, Kotton CN, ASTIDCo P. Travel medicine, transplant tourism, and the solid organ transplant recipient-guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transpl. 2019;33:e13529. https://doi.org/10.1111/ctr.13529.

    Article  Google Scholar 

  29. Blumberg EA, Rogers CC, American Society of Transplantation Infectious Diseases Community of Practice. Solid organ transplantation in the HIV-infected patient: guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transpl. 2019;33:e13499. https://doi.org/10.1111/ctr.13499.

    Article  Google Scholar 

  30. Epstein DJ, Subramanian AK. Prevention and management of tuberculosis in solid organ transplant recipients. Infect Dis Clin N Am. 2018;32(3):703–18. https://doi.org/10.1016/j.idc.2018.05.002.

    Article  Google Scholar 

  31. Pouch SM, Friedman-Moraco RJ. Prevention and treatment of clostridium difficile-associated diarrhea in solid organ transplant recipients. Infect Dis Clin N Am. 2018;32(3):733–48. https://doi.org/10.1016/j.idc.2018.05.001.

    Article  Google Scholar 

  32. Acuna SA, Huang JW, Scott AL, et al. Cancer screening recommendations for solid organ transplant recipients: a systematic review of clinical practice guidelines. Am J Transplant. 2017;17(1):103–14. https://doi.org/10.1111/ajt.13978.

    Article  CAS  PubMed  Google Scholar 

  33. Ladin K, Emerson J, Berry K, et al. Excluding patients from transplant due to social support: results from a national survey of transplant providers. Am J Transplant. 2019;19(1):193–203. https://doi.org/10.1111/ajt.14962.

    Article  PubMed  Google Scholar 

  34. Maldonado JR, Dubois HC, David EE, et al. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics. 2012;53(2):123–32. https://doi.org/10.1016/j.psym.2011.12.012.

    Article  PubMed  Google Scholar 

  35. Dew MA, DiMartini AF, Dobbels F, et al. The 2018 ISHLT/APM/AST/ICCAC/STSW recommendations for the psychosocial evaluation of adult cardiothoracic transplant candidates and candidates for long-term mechanical circulatory support. J Heart Lung Transplant. 2018;37(7):803–23. https://doi.org/10.1016/j.healun.2018.03.005.

    Article  PubMed  Google Scholar 

  36. Surman OS, Cosimi AB, DiMartini A. Psychiatric care of patients undergoing organ transplantation. Transplantation. 2009;87(12):1753–61. https://doi.org/10.1097/TP.0b013e3181a754d4.

    Article  PubMed  Google Scholar 

  37. Heinrich TW, Marcangelo M. Psychiatric issues in solid organ transplantation. Harv Rev Psychiatry. 2009;17(6):398–406. https://doi.org/10.3109/10673220903463259.

    Article  PubMed  Google Scholar 

  38. Dew MA, DiMartini AF, De Vito Dabbs A, et al. Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation. 2007;83(7):858–73. https://doi.org/10.1097/01.tp.0000258599.65257.a6.

    Article  PubMed  Google Scholar 

  39. Foster BJ, Dahhou M, Zhang X, Platt RW, Samuel SM, Hanley JA. Association between age and graft failure rates in young kidney transplant recipients. Transplantation. 2011;92(11):1237–43. https://doi.org/10.1097/TP.0b013e31823411d7.

    Article  PubMed  Google Scholar 

  40. Anis KH, Weinrauch LA, D’Elia JA. Effects of smoking on solid organ transplantation outcomes. Am J Med. 2019;132(4):413–9. https://doi.org/10.1016/j.amjmed.2018.11.005.

    Article  PubMed  Google Scholar 

  41. Levi ME, Montague BT, Thurstone C, et al. Marijuana use in transplantation: a call for clarity. Clin Transpl. 2019;33(2):e13456. https://doi.org/10.1111/ctr.13456.

    Article  Google Scholar 

  42. Network OPaT. National data: Organ by state, current U.S. waiting list. Secondary national data: Organ by state, current U.S. waiting list 2019. https://optn.transplant.hrsa.gov/data/view-data-reports/national-data.

  43. Valapour M, Lehr CJ, Skeans MA, et al. OPTN/SRTR 2016 annual data report: lung. Am J Transplant. 2018;18(Suppl 1):363–433. https://doi.org/10.1111/ajt.14562.

    Article  PubMed  Google Scholar 

  44. Ahya VN, Diamond JM. Lung transplantation. Med Clin North Am. 2019;103(3):425–33. https://doi.org/10.1016/j.mcna.2018.12.003.

    Article  PubMed  Google Scholar 

  45. Wong CJ, Pagalilauan G. Primary care of the solid organ transplant recipient. Med Clin North Am. 2015;99(5):1075–103. https://doi.org/10.1016/j.mcna.2015.05.002.

    Article  PubMed  Google Scholar 

  46. Ettenger R, Albrecht R, Alloway R, et al. Meeting report: FDA public meeting on patient-focused drug development and medication adherence in solid organ transplant patients. Am J Transplant. 2018;18(3):564–73. https://doi.org/10.1111/ajt.14635.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christopher J. Wong .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Zhong, D., Wong, C.J. (2020). Overview of Solid Organ Transplantation for Primary Care Providers. In: Wong, C. (eds) Primary Care of the Solid Organ Transplant Recipient. Springer, Cham. https://doi.org/10.1007/978-3-030-50629-2_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-50629-2_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-50628-5

  • Online ISBN: 978-3-030-50629-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics