Residency Curriculum Modules: Transplant Rehabilitation with Sarah Eickmeyer, MD-Facilitator's Guide- Transplant Rehab

Facilitator's Guide- Transplant Rehab

Pdf Summary

The Residency Curriculum module on Transplant Rehabilitation offers an interdisciplinary educational framework focused on post-solid organ transplant patient care in inpatient rehabilitation settings. It includes three core videos addressing medical considerations (immunosuppression, rejection, complications), rehabilitation factors (physiological impacts, recovery expectations, team collaboration), and emergency management (rejection, infection, encephalopathy).<br /><br />A case-based discussion centers on a 55-year-old heart transplant recipient transitioning from independence to moderate assistance needs. Facilitated questions prompt exploration of training for nursing, therapy, PM&R, and overnight teams with emphasis on activity precautions, recognizing acute rejection, and emergency protocols. Discharge planning highlights patient/caregiver education on immunosuppression and infection precautions, coordination with knowledgeable outpatient and skilled nursing providers, and social work involvement to address follow-up barriers.<br /><br />Inpatient rehab goals focus on regaining mobility and ADL independence, typically over 7–10 days, adjusted for complications like ICU-acquired weakness. Monitoring addresses rejection signs (fatigue, dyspnea), infection risks, and cognitive changes via labs, echocardiography, biopsy, and cognitive assessments. Education resources include team members like transplant pharmacists and structured materials to ensure patient and caregiver understanding of immunosuppressive regimens, which commonly consist of prednisone, tacrolimus or cyclosporine, and mycophenolate or azathioprine, with vigilance for side effects.<br /><br />Clinical reasoning around therapy intolerance considers the denervated heart’s altered physiological responses, necessitating graded activity progression and reliance on perceived exertion scales over heart rate. Collaboration between medical and therapy teams emphasizes gradual warm-ups, real-time communication, and endurance-based functional goals.<br /><br />The guide is supported by key literature spanning heart, lung, and liver transplantation rehabilitation, immunosuppression management, ICU-acquired weakness, cognitive impairment post-critical illness, and outcomes research, providing comprehensive evidence-based context for optimizing interdisciplinary transplant rehabilitation.

Keywords

Transplant Rehabilitation

Solid Organ Transplant

Inpatient Rehabilitation

Immunosuppression

Acute Rejection

Emergency Management

Discharge Planning

ICU-Acquired Weakness

Physiological Impacts

Interdisciplinary Team