Dental Management Chapter 21 Organ and Bone marrow transplant

What is the most transplanted organ in the US?

kidney

Corticosteroid blocks _______ gene transcription, broadly immunosuppressant

cytokine

Calcineurin inhibitor are immunosuppresant that inhibits IL-2 gene reducing T cell activation

Example include ________ and Tacrolimus

Cyclosporine

What are the common cancer risk in organ transplant recipients?

Nonmelanoma skin cancer and oral squamous cell carcinoma

Signs and Symptoms of GVHD in skin and oral

Skin: Poikiloderma (lichen planus like)

Oral: Lichen planus like

Should antibiotic therapy be given to transplant pt?

Only heart transplant

Other just chlorohexidine

3 phases of pt transplantation

Immediate posttransplant

Stable graft period

Chronic rejection

When can elective dental treatment be given?

Immediate posttransplant is less than or equal to 6 months

Only in stable graft period (never immediate posttransplant)

Unless emergency

Oral complication of alloHCT

Oral mucositis

Chronic GVHD

_______ has been associated with oral soft tissue pyogenic granuloma-like lesions

Tacrolimus

mTOR inhibitor is assoicated with development aphthous like oral ulcers

What are example

Ends in limus

Sirolimus and Everolimus

Invasive fungal infection (most frequently ________) may present intraorally as an ulcerated mass, typically in the maxilla as an extension of sinopulmonary involvement.

aspergillus

CMV reactivation rarely causes painful nonspecific ulcerations that require biopsy and immunostaining for diagnosis. Management is ________

ganciclovir