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22 Cards in this Set
- Front
- Back
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Transplant
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Standard of Care for END STAGE Organ Disease
25,000 / year |
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Types of Transplants 1
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Allograft (homograft) – same species
Autologous – within same individual Xenogeneic (heterograft) – between different species Allogeneic – same species; different genes but HLA match Syngeneic ( isograft) – between individuals with identical genes |
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Types of Transplants 2
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Orthotopic – transplant organ/tissue into normal anatomic location
Heterotopic – diseased organ left in place with donor organ parallel Homologous – similar in structure, position, origin (human heart, baboon heart) Combined Organ Transplants – multiple organ transplant from a single donor Organ Retransplantation – occurs because of graft rejection, mechanical failure, recurrence of primary disease |
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Getting Donors and Who Gets Them
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Organi Distribution Center
Organ Donations Criteria for Organ Candidates (Pretransplant Eval) |
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Advances in Transplants
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Advances in immunology, organ preservation, surgery, pharmacology, post-op care
Xenotransplantation -- organs from other species (pigs mostly) Tissue engineering -- science of gowing living Human tissue for transplantation Meds |
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Biopsychoemotional Implications
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Legal and Ethical, Bioethical, Psychoemotional Considerations
- Pre/Post Transplants |
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Posttransplant Complications
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Surgical
Ischemic Reperfusion Injury - oxygen comes back into the tissue and can injure it by rapid oxidation Immunosuppressive Agents - used to prevent rejection can cause complications |
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Posttransplant Rejection
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Graft Rejection - hyperacute/acute/chornic rejection
Graft Vs Host Disease - Acute or Chronic, --Major Toxicity for Bone Marrow Transplant --Sx: Rash, hepatitis, diarrhea, vomit --Acute Prescription - drugs --Chronic Prescription: immunosuppressive therapy |
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Histocompatibility
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Tissue Typing
Done before to see if rejection is likely |
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Immunosuppression Complication
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Block Transplant Candidate Reactivity to Donor's Organ
Helps stop rejection by immune system Side Effects: Cancer, Hyperllipidemia Osteoporosis, Neurotoxin Rxns |
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Graft Vs Host Disease - Acute or Chronic,
(graft and host recognize each other as foreign) |
Graft Vs Host Disease - Acute or Chronic,
--Major Toxicity for Bone Marrow Transplant --Sx: Rash, hepatitis, diarrhea, vomit --Acute Prescription - drugs --Chronic Prescription: immunosuppressive therapy |
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Exercise, Activity, Sports with Transplant
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Pretrans -- Wkness, Short of Breath, fatigue, emphasize LE
Posttrans -- Increases exercise capcity, endurance, strength Limitations -- No Contact Sports, Long-term Immunosuppressive Therapy, Denervation of Transplanted Organ |
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Blood and Bone Marrow Transplant
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Hematopoietic Stem Cell Transplant
Transplant blood or marrow stem cells Come from bone marrow or placental cord blood Transplant type - syngeneic, autologous, allogeneic |
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BMT = Bone Marrow Transplant
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Used following high-dose chemotherapy or radiation
-Leukemia, Multiple Myeloma, Lymphoma, Renal, Testicular Pre-Conditioning --> Harvest Marrow --> Infuse Marrow (thru IV) --> Blood Cell Transfusions for 10-20 days --> Engraftment 2-3 weeks for stem cells to gronw in marrow |
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HSCT = Hematopoietic Stem Cell Transplant
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Transplant blood or marrow-dervied stem cells
Sources: bone marrow, peripheral blood, placental/umbilical cord blood TYPE: Syngeneic, Autologous, Allogeneic |
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BMT is used following ___________
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High-dose Chemotherapy or Radiation to treat disease
usually Cancer |
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Laboratory procedure in which white blood cells are separated from a sample of blood
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Leukapheresis
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Graft vs Host Disease: What happens?
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Donor's Bone Marrow REJECTS the body
T-cells attack the normal tissue Acute: 0-3 months Chronic: 3 months - 3 years IMPACTS SKIN, LIVER, INTESTINES. |
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What Sx present with GVHD?
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GI Tract - intestine inflam, slough of mucous membranes, severe diarrhea, abdominal pain, vomiting/nausea
Liver - Jaundice Skin - lacy pattern rash |
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BMT Tx and Px
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Donated stem cells treated to remove the WBC thru T-cell depletion, Steroids, Immunosuppressant Therapy
Px: High morbidity and mortality 5 year survival is good (93% in good health) |
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Rehab Considerations for Transplant
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Prevent Loss of Strength and Endurance
Peripheral Neuropathy Steroid Myopathy Tx of fibrotic tissue via GVDH Osteopenia BLOOD COUNT PRECAUTIONS |
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Organs that can be transplanted
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Kidney, Liver, Heart,
Lung, Pancreas, Intestine, Skin, Ovary |
