Trauma patients with a previous organ transplant
| Autor: | Thomas M. Scalea, Jay Menaker, Mary E. Kramer, Mark E. Cooper, Adam K. Meeks, Joseph A. Kufera, Stephen T. Bartlett, Joseph R. Scalea, Kimberly M. Auman |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Kidney Critical Care and Intensive Care Medicine Organ transplantation chemistry.chemical_compound Injury Severity Score Trauma Centers Internal medicine medicine Humans Registries education Aged Retrospective Studies Inflammation Creatinine education.field_of_study business.industry Trauma center Immunosuppression Retrospective cohort study Organ Transplantation Length of Stay Middle Aged Kidney Transplantation Liver Transplantation Treatment Outcome Traumatic injury chemistry Wound Infection Wounds and Injuries Female Surgery business Immunosuppressive Agents |
| Zdroj: | Journal of Trauma and Acute Care Surgery. 74:1498-1503 |
| ISSN: | 2163-0755 |
| Popis: | BACKGROUND Few reports are available concerning outcomes following trauma in transplanted patients. Investigating outcomes for patients in this population may yield helpful information about both immunosuppression and inflammatory responses. METHODS This was a retrospective study. The trauma registry was used to identify all patients with a history of solid-organ transplant who were admitted to the trauma center between January 2007 and June 2011. Data were stratified by age, sex, Injury Severity Score (ISS), and length of stay (LOS). RESULTS During the study period, 50 patients admitted for traumatic injury also had previous organ transplants. We found that white blood cell count was significantly lower for transplanted patients (p < 0.001) and remained significantly lower at each stratification criteria. In addition, LOS was either lower or no different for transplanted patients when data were stratified. Only one patient explicitly had an injured graft (a kidney) secondary to trauma at the time of admission. This resulted in acute renal failure and a doubling of the serum creatinine. Three patients had questionable graft injuries, but graft function remained normal. Seventeen percent of patients developed acute rejection following admission for trauma. CONCLUSION Outcomes following injury in patients with previous organ transplant are not worse than outcomes for nontransplanted patients, and transplanted organs are infrequently injured. Prospective data are needed to understand better the balance of inflammatory and anti-inflammatory mediators following acute injury in this population. LEVEL OF EVIDENCE Therapeutic/care management, level III. |
| Databáze: | OpenAIRE |
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