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29 Cards in this Set
- Front
- Back
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What is an autograft?
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transplantation of tissue from one body part to another
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What is a heterograft?
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transplantation of tissue between two species
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What is an allograft?
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tissue between members of the same species (living or dead)
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What are the two types of death that are common organ donors?
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cardiac and brain
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What did the Uniform Determination Death Act do?
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determines cardiac death and provides guidelines for determination of brain death
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What three factors must be known prior to testing for brain death?
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1. cause of unresponsiveness
2. absence of metabolic CNS depression 3. absence of toxic CNS depression |
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How to determine brain death through clinical exam findings. (8)
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1. GCS of 3
2. no pupillary response to light 3. negative dolls eyes 4. negative cold calorics 5. no blink reflex 6. no cough with deep suctioning 7. no gag response 8. apnea *cold calorics- they squirt water into the ear, that eye will turn to the ear |
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Suitability criteria for donation (3)
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1. PMH
2. hemodynamic status 3. consent |
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What types of donor testing are performed on the donor?
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serum labs for transmittable diseases
blood type and HLA organ evaluation (heart, lungs, liver, pancreas, kidneys) *HLA- human leukocyte antigen, part of the immune system in humans. |
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Describe the matching process for donors and recipients
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1. It is decided that said organ will be donated.
2. donor information is loaded onto UNET, a site run by UNOS. this will provide a list of all national patients who match this donor 3. The transplant center is notified 4. the transplant team considers the donor organ 5. the recipient is chosen and notified |
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What are the 3 major histocompatibility complexes?
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1. antigens
2. MHC1 antigens 3. MHC2 antigens |
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What donor-recipient compatiblity tests are performed/.
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tissue type and crossmatching, and ABO typing
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How is the determination of transplant need made?
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UNOS (the united network for organ sharing) decides. The person must be in the end stage of organ disease with a short life expectancy and suffer a functional disability.
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How is the recipient evaluated prior to being chosen to recieve an organ?
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clinical status, nutritional status, psychological status, and financial status
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What are the three types of complications post transplant?
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technical complications, graft rejection, and immunosuppressant related problems.
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What are types of technical complications?
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vascular thrombosis, bleeding, and anastomosis leakage
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What are types of graft rejection?
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hyper-acute rejection, acute rejection, chronic rejection
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What are immunosuppressant related problems?
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infection, organ dysfunction, malignancy, steroid induced problems
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What are the types of immunosuppresant therapies?
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cyclosporine, corticosteroids, antimetabolities, antibodies, and macrolide antibiotics
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What are Cyclosporines?
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They have a high degree of specificity for helper T cells.
Side effects: hepatoxicity, nephrotoxicity, neurotoxicity, hyperglycemia, hirsuitism, and gingival hyperplasia Examples: sandimmune, neural, gengraff |
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How do corticosteroids help post transplant?
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they have anti-inflammatory and immunosuppresent activities. They decrease the number of t-lymphocytes. they decrease B lymphocyte production. Long term use can cause severe bone disorders, diabetes mellitus, cataracts, and decreased wound healing.
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What are antimetabolites?
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They are cytotoxic agents
side effects: anemia, thrombocytopenia, and leukopenia Examples: azathiprine, imuran, mycophenolate mofetil, cellcept |
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What are antibodies and how are they used post transplantation?
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Monoclonal Antibiodies (OKT3) are used as rescue therapy or during the early post transplantation period.
new agents include simulect and zenapax |
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What are macrolide antibiotics nad how are they used post transplant/
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They inhibit T cell proliferation, and suppress the immune response
Example: tacrolimus/sirolimus/prograff/rapamune |
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What is the main reason for kidney transplants?
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end stage renal disease
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What is involved in the post operative management of kidney transplant?
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IVFs to keep UO >100mL/hr
diuretics VS with CVP readings I&Os drug levels (CsA, tacrolimus, sirolimus) antibiotics labs |
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What is the post operative management of Heart, heart/lung, and lung transplants?
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-loss of cardiac autonomic innervation
-hemodynamic/cardiac monitoring -pharmacological therapy -fluids and electrolytes -monitoring renal function -monitor for s/sx of respiratory alterations -prevent infection |
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What is the post operative management of a liver transplant?
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Maintain normal liver function! this requires bile drainage, labs, and neuro status checks
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what is the post operative management of a pancreas and pancreas/kidney transplant?
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prevent and treat- infection, thrombosis, dehydration, acidosis, hyperinsulinemia, rejection, and monitor urine output
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