Thai Journal of Gastroenterology

Article :
Post Transplantation Diarrhea

Author :
Monthira Maneerattanaporn, M.D. Sataporn Manatsatit, M.D.

Abstract :

                  Diarrhea in transplant recipient is a common clinical finding.  It is especially important to differentiate between infection and GI-GVHD because treatment for both conditions is contradictory.  The timeline of infection sequences and findings in each condition must be evaluate thoroughly.  New technology is needed to be used for early detection, monitor immune function and new therapies are needed to overcome the antimicrobial resistance. In transplant recipients, receiving immunosuppressive therapy, their inflammatory responses can be blunted and make their clinical presentations insidious and occult in the early stage but they may be turned deteriorate rapidly in late course of infection when compared to the normal host. The transplanted organ appears to be more susceptible to CMV infection than the native organs. CMV remains a significant cause of morbidity and mortality following allogeneic transplantation.  More expansion of the potential donor pool in order to facilitate more widespread application of transplantation led to the use of conditioning protocols or post-transplantation immunosuppressive regimens that result in more profound immune suppression to reduce the risk of graft-versus-host disease (GVHD).

[Thai J Gastroenterol 2006; 7(1): 22-36]

Keyword :
Post transplantation, Diarrhea, immunosuppressive agents, GVHD

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