**Author details**

*Perioperative Care for Organ Transplant Recipient*

Patients are ordered antifungal prophylaxis on admission to the

ICU. Voriconazole (Vfend) is the first-line agent. Amphotericin B lipid complex (Abelcet) will be ordered for patients with intolerance to voriconazole (Vfend).

The patient is ordered Bactrim DS one (I) tab Monday, Wednesday, and Friday when the patient is discharged following transplant. Atovaquone (Mepron) 750 mg every 12 h is substituted or monthly inhaled pentamidine for patients with a sulfa allergy. PCP prophylaxis is given throughout the patient's posttransplant course.

Cytomegalovirus (CMV) prophylaxis is initiated on the POD# 1 based on the donor and recipient CMV status. CMV infection following the completion of the prophylaxis is treated at the induction dose for 3 weeks then decreased to the maintenance dose. Duration of therapy is determined in consultation with the

Lung transplantation has evolved as the gold standard for selective patients with end-stage lung disease but remains limited by a critical donor shortage. Perioperative management of lung transplant recipients is a highly complex endeavor. National registry data reveal progressively improving early as well as long-term survival. Optimal perioperative outcomes are dependent on preemptive, well-coordinated, and multidisciplinary management strategies. Certain high-risk patient subsets with end-stage lung disease such as highly sensitized patients, and those with concomitant severe CAD present unique challenges requiring specialized

We, the authors, would especially like to express our heartfelt gratitude to the entire lung transplant team at our institution for their professionalism, dedication,

and support so generously offered to us during this endeavor.

**3.6 Antimicrobial prophylaxis**

*3.6.1 Antifungal prophylaxis*

*3.6.2 PCP prophylaxis*

*3.6.3 CMV prophylaxis*

**4. Conclusions**

perioperative management.

**Acknowledgements**

**Conflict of interest**

There are no conflicts of interest.

Transplant Infectious Disease physician.

**110**

Stacey H. Brann\*, Steven S. Geier, Olga Timofeeva, Norihisa Shigemura, Francis Cordova and Yoshiya Toyoda Temple University Hospital, Philadelphia, USA

\*Address all correspondence to: stacey.brann@tuhs.temple.edu

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
