Board Certification Review 2023 Spotlight: Cardiac Transplantation-Faculty Panel Q&A

Video Transcription
Video Summary
The video discussed various topics related to transplant medicine. Some key points include:<br /><br />- Patient tolerance to Everolimus and Serolimus: Although no randomized control trials have been conducted, it was noted that patients tend to have a lower tolerance to Everolimus. If a patient experiences intolerable adverse effects to Everolimus, switching them to Serolimus may be an option.<br />- Denervation of the heart: It was mentioned that evidence of reinnervation in the heart typically does not occur until the second year after transplant. However, the physiological effects of reinnervation are still unknown.<br />- Logistics of pre and post-test questions: Pre-test questions are available before a session starts and up to about five minutes into the session. They should be completed immediately prior to or at the beginning of the session. Post-test questions are available as CME activities are completed and completion of post-test questions grants access to explanatory information about the correct answers.<br />- Use of SGLT2 inhibitors in post-transplant patients with chronic kidney disease: Although there is limited data on the use of SGLT2 inhibitors in post-transplant patients, there is reason to believe they may be beneficial. However, the risk of genitourinary infections, particularly in patients with diabetes, should be considered.<br />- Management of immunosuppression in transplant patients: Management of immunosuppression may vary depending on specific situations such as pregnancy or primary graft dysfunction. It is important to consider factors such as drug levels, genetic testing, and monitoring for rejection.<br />- Tachyarrhythmias in transplant patients: The approach to tachyarrhythmias in transplant patients may vary depending on the type of arrhythmia. Sinus tachycardia may not necessarily require intervention, while atrial arrhythmias may require interventions such as catheter ablation or antiarrhythmic medications.<br />- Allograft vasculopathy: Allograft vasculopathy is different from traditional coronary artery disease and often does not respond well to macrovascular interventions. Revascularization may be considered in patients with extensive macrovascular obstruction, but retransplantation may be necessary for those with significant microvascular obstruction.<br /><br />These are just some of the main points discussed in the video, providing a brief overview of the content.
Keywords
transplant medicine
patient tolerance
reinnervation
SGLT2 inhibitors
immunosuppression management
allograft vasculopathy