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13 Cards in this Set
- Front
- Back
When/what were the first immunosupressive drugs discovered?
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1959, 6 metacaptopurine and azathioprine.
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What is rejection; hyperacute?
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Minutes/hours due to preformed Ig (pregnancy, transfusion). Facilitated by complement or platelet adherence to donor endothelium.
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What is rejection; acute?
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Days/weeks due to cellular (B/T/macrophage) response.
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What is rejection; chronic?
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Months/years due to a 'grumbling' response (that is largely idiopathic.)
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True or false: Cadaveric transplants are better than live.
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FALSE: living is better.
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Name one of the two types of cadaveric organ. (1)
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Heart beating; brain stem death.
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Name the five components of a test for brain stem death.
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Fixed pupils, corneal reflex, absent ocular-vestibular reflex, no response to supraorbital pressure and no cough response to bronchial stimulation.
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Name one of the two types of cadaveric organ. (2)
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Non-heart beating. There will only be a few minutes to save the heart before ischaemia and system wide clotting kick in.
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What is a better: spousal or parental donor?
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Spousal. Sonewhat counterintuitive but this is to do with age not HLA/tissue matching.
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What are the risks of transplantation (three)?
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Infection (both viral - CMV - and bacterial), malignancy (commonly skin - melanom is the most common cancer post transplantation) and side effects of immunosuppression.
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How is ABO incompatibility overcome?
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Pretransplant plasmapheresis + recipient immunosuppression to decrease preformed Ig resulting in desensitisation of a cross-matched positive transplantation.
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What is accomodation?
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Normal graft function in face of anti-donor Ig without signs of rejection.
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What are the implications of achieving wide spread tolerance?
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Removal of need for immunosuppression. No drug related side effects or chronic rejection. Impact on organ shortage and indefinite graft survival.
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