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What type of transplant did you have?

When did you have your transplant?

What was the underlying condition for which you required the transplant?

Have you experienced any oral complications?

What are your present laboratory values?

What types of medications are you taking?

What type of transplant did you have?

Solid organ transplants (grafts) are indicated when specific organs (eg, kidney, liver, pancreas, intestine, heart, and lung) are failing.

Hematopoietic stem cell transplants (HSCT, formerly known as bone marrow transplants [BMT]) are usually indicated for neoplasms, some autoimmune disorders, and some immunodeficiency disorders.

When did you have your transplant?

The longer the patient has survived without complications after a transplant, the more stable the graft and the patient.

Rejection of a transplant is a very serious complication and can occur at various times after transplantation.

  • Hyperacute rejections occur minutes to hours after transplantation
  • Acute rejections occur within days to weeks; and
  • Chronic rejections occur months to years post-transplant.

What was the underlying condition for which you required the transplant?

Although a transplant has been performed, some underlying pathologic conditions may still be present or may reemerge. Furthermore, some types of transplants may predispose the patient to other diseases affecting the same or other organ systems.

For example, heart transplant patients may develop ischemic heart disease and have a diminished vagal response, or patients with longstanding renal failure may still have an increased susceptibility to bacterial endocarditis.

Have you experienced any oral complications?

Oral complications are common when patients are severely immune suppressed or exhibit immune dysfunction. Common complications include lesions associated with Graft-Versus-Host Disease, different herpes virus infections , candidiasis , side effects due to medications .

Fungal infections are more common immediately post-transplant; herpes simplex virus infections usually occur within 1-2 months; other herpes infections may occur within 1-10 months post-transplant.

What are your present laboratory values?

Possible bone marrow suppression and, for pre-transplant patients, severity of the end-stage disease should be addressed.

A complete blood cell count with a differential cell count and disease-specific laboratory values are always indicated for both pre- and posttransplant patients.

What types of medications are you taking?

All transplant recipients must receive immunosuppressive therapy for various periods of time. The most common medications are cyclosporine analogs, tacrolimus, sirolimus, azathioprine, mycophenolate mofetil, mono- and polyclonal antibodies, and corticosteroids.

All immunosuppressive medications are associated with significant side effects

In addition, concomitant antimicrobial (eg, antibiotic, antiviral, antifungal) therapy is also indicated.

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