If surgery for problems other than those related to the graft is necessary, complications secondary to chronic steroids and immunosuppression should be anticipated. Also, caution must be taken in the presence of a coagulopathy. It is recommended that immunosuppression not be stopped unless there is sepsis, in which case the immunosuppression might need to be reduced. Two series looking at cardiac and general surgery showed no documented decline in graft function and no need for stress dosing of steroids.1 ,19

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