Cardiac Transplant Flashcards
(17 cards)
What is the purpose of cardiac transplant?
A viable treatment option for end-stage heart disease.
What advancements have enabled cardiac transplants?
Advancements in surgical techniques and improved immunosuppressive therapies.
Name two immunosuppressive therapies used in cardiac transplants.
Cyclosporine (Neoral, Sandimmune) and Tacrolimus (Prograf).
What are the indications for cardiac transplant?
Cardiomyopathy, ischemic heart disease, valvular disease, rejection of a previously transplanted heart, and congenital heart disease.
What is a typical patient presentation for cardiac transplant?
Severe symptoms uncontrolled by medical therapy, no other surgical options, and life expectancy estimated to be <2 years.
What criteria are used for patient screening in cardiac transplant?
Age, pulmonary function, presence of chronic illnesses, psychosocial and family support, infection history, history of prior transplants, compliance with medical care, and current health status and stability.
What factors determine heart allocation on the waitlist?
ABO compatibility, body size of donor and recipient, age, severity of illness, length of time on waitlist, and geographic location.
What is the time-sensitive aspect of cardiac transplant?
Transplant must occur within 4 hours of organ procurement.
What is the transplant procedure for cardiac transplant?
Orthotopic transplantation: Diseased heart is removed and replaced.
What are the three classes of immunosuppressants used post-transplant?
Corticosteroids (e.g., Prednisone), calcineurin inhibitors (e.g., Cyclosporine, Tacrolimus), and antiproliferative agents (e.g., CellCept, Imuran).
What is a key physiological change in the transplanted heart?
Denervated: No connection to sympathetic or vagus nerves.
What are common complications post-transplant?
Accelerated atherosclerosis, hypertension, osteoporosis, cancer risk, weight gain, diabetes, dyslipidemia, hypotension, renal failure, CNS, respiratory, and GI disturbances, and drug toxicity.
What psychosocial stressors may patients experience post-transplant?
Survivor guilt, anxiety, depression, and fear of rejection.
What should nurses monitor in the nursing process for cardiac transplant patients?
Assess for complications, monitor for signs of rejection, ensure medication adherence, and provide psychosocial support.
What is a Ventricular Assist Device (VAD)?
A support device for patients with severe heart failure, used for short-term or long-term support.
What are the uses of VAD?
Bridge to recovery, bridge to transplant, and destination therapy for patients ineligible for transplant.
What are common complications associated with VAD?
Bleeding disorders, hemorrhage, thromboembolic events, hemolysis, infection, renal failure, and multisystem organ failure.
