4: Renal transplantation Flashcards Preview

Renal Week 3 2017/18 > 4: Renal transplantation > Flashcards

Flashcards in 4: Renal transplantation Deck (54)
Loading flashcards...
1

Apart from dialysis, what can be offered to patients with end-stage CKD?

Kidney transplant

2

What is the best option out of dialysis and renal transplant?

Renal transplant

by far

3

Which type of renal transplant has the best prognosis?

Those from LIVE, RELATED donors

e.g your bro

4

What CKD stage corresponds with end-stage disease?

What is the GFR threshold?

CKD5

GFR < 15

5

What GFR will patients achieve at best

a) on dialysis

b) after a transplant?

a) 7 (so they'll still feel miserable)

b) 50 (more freedom, better QOL)

6

From which groups of donors can transplants be taken?

Live donors

Cadaveric donors

7

___ is required to prevent organ rejection.

Immunosuppression

8

Which patients are less likely to receive kidney transplants?

Why?

Elderly

Co-morbidities, less likely to achieve good outcomes

9

In which situations are organs taken from cadaveric donors?

Brain stem death (so intubated, HB but no signs of life)

No heart beat (very rapidly after death)

organs taken very rapidly and transported to patient

10

Why are cadaveric organs from brain stem death donors more useful than those from recently dead donors?

Brain stem death - organs still perfused

Recently dead - "ischaemic hit"

11

Donation from living donors is also known as ___ donation.

altruistic

charitable, generous

12

Organ donation involving the exchange of money/services is ___.

illegal

in the UK

13

Patients with CKD5 are only considered for transplant if they are going to live for more than ___ years.

five years

14

What affects a patient's suitability for surgery?

Age

Co-morbidities - frailty, bleeding, CVD

Response to anaesthetic

Immunosuppressed

15

What must the donor be assessed for before somebody receives their organ?

Infection

stuff like hepatitis, HIV, cytomegalovirus...

16

How is a patient's CVD and pulmonary risk assessed before they receive a transplant?

ECG

Echocardiogram

Chest X-ray, pulmonary function tests

17

What organ structures must be checked before a patient receives a renal transplant?

Current renal blood supply

Bladder

18

What are conditions are contraindications to renal transplant?

Malignancy

Active infection

why would you immunosuppress these patients

otherwise: severe CVD, respiratory problems

19

What contraindicates someone from donating a kidney?

Not physically fit

Poor renal function - existing renal disease?

Co-morbidities - e.g DM

Kidneys not structurally, immunologically suitable

Donor is being cooerced

20

Donors with blood group ___ can donate to anyone.

O

21

What are the four blood groups?

O

A

B

AB

compatible with what the other person's got

O covers all

22

How are tissues matched in organ donation?

Blood group

HLA genotype

23

If the donor tissue doesn't match the recipient's blood group and HLA genotype, what occurs?

Rejection

24

What events can sensitise patients to antigens and predispose them to organ rejection?

Blood transfusion

Pregnancy

Previous transplant

25

Why may a woman be sensitised to her husband's kidneys?

Coincidental

Previous pregnancy

26

Which patients are given priority on the kidney transplant list?

Children

27

How can patients be desensitised to donor tissue?

Plasma exchange

Biologics (e.g rituximab - B cell inhibitor)

28

What is the down side of desensitisation?

Further immunosuppression

so patient is at less risk of rejection but increased risk of all the side effects

29

Where is the incision made in a kidney transplant?

Iliac fossa

30

Which artery and vein are transplanted kidneys connected to?

External iliac artery

External iliac veins