Renal Transplant Flashcards
What are the advantaged of transplant?
Near normal lifestyle
Better mortality/morbidity
What are the disadvantages of transplant?
Criteria to meet Lifelong compliance to medication Risk of rejection RIsk of infection Risk of malignancy Waiting times
What are contraindications for transplant?
Active infection Malignancy Severe heart or lung disease Reversible renal disease Treat non-adherence
What are the types of transplant?
Living related donor
Living unrelated donor
Deceased donor
What is living related donor transplant?
Transplant from a known living donor
Can be done in months
What is living unrelated donor transplant?
Live-donor paired exchange
Live-donor/deceased-donor exchang e
Live-donor chain
Altruistic donation
Can be done in months
What is deceased donor transplant?
Kidney from deceased donor
Can happen very suddenly
Can take years to find donor
What is the induction treatment?
Methylprednisolone + basiliximab/thymoglobulin
What is the maintenance treatment?
Used immediately after transplant
Steroid - prednisolone
Calcineurin inhibitor - tacrolimus, cyclosporin
Antimetabolite medications - mycophenolate, azathioprine
Rapamycin inhibitors - sirolimus, everolimus
T-cell regulation - belatacept, belimumab
What is long term care for a transplant recipient?
Monitor
- GFR
- CNI levels
- Calcium
- Phosphate
- Lipids
- Glucose
Screen for infections
Vaccination
Contraception
What are complications of transplant?
Infection
- <4 weeks = nosocomial infection or donor related
- 1 to 12 months = activation of latent infections
- > 12 months = community acquired
New onset diabetes
Malignancy
