Trauma management in solid organ transplant recipients

Abstract

With trauma being common in this country and over 110,000 recent organ transplants performed, transplant recipients may become trauma victims. At present, only a few older small series of traumatized transplant patients exist. At the University of Arkansas, over the past 40 months, 12 patients with significant trauma were retrospectively identified (seven with kidney and five with combined kidney and pancreas transplants). The most common causes of trauma were car accidents and falls. All patients suffered closed skeletal fractures, and no transplanted organs were directly injured or lost. Complications included death, deep vein thrombosis, renal failure, sepsis, and pneumonia. In spite of immunosuppression and preexisting renal osteodystrophy, fractures in the surviving patients healed, with a mean follow-up of 15 months. A large series of traumatized transplant patients is presented with a review of the management of traumatic injuries for each type of organ transplant. A trauma transplant registry is needed to formulate appropriate management and follow-up.