Living Donation and Transplantation Flashcards
(17 cards)
What is required from a living donor to give consent?
4 items
- competent
- willing
- free from coercion
- informed of risks
- alternatives to treatment available to recipient
When must ABO verification for living donor transplant be done?
2 items
- immediately before removal of donor organ
- prior to implanatation in recipient on day of surgery
Living donor evaluation requirements include…
Be familiar with the following…
- No solicitation of donors
- Have separate donor and recipient teams
- Assign an Independent Donor Advocate
- Emphases on health and safety of donor
What are the responsibilities of the living donor advocate?
Be familiar with the following…
- Ensures protection of rights
- Function independently of recipient team
- Must follow written protocols of transplant program
- Ensure donor receives all information, including informed consent, evaluation process, surgical procedure, medical risk, psychological risk, and follow-up care
What should education include for living donor candidates?
7 items
- donor evaluation
- surgical procedure
- recuperation period
- short and long-term follow up care
- alternatives to live donation
- potential psychiatric benefits/risks
- potential medical and financial risks
Which of the following are recommended to NOT be a living donor candidate? (more than 1 may apply)
A. > 18 years of age
B. Blood relatives of recipient
C. Extended family of recipient
D. Non-blood related family members
E. Close friends or acquaintances
F. Altruistic donors
G. The recipient’s employer
H. Someone that is paid for donation
G, H
What are absolute contraindications of kidney living donation?
7 items
- kidney disease
- diabetes
- heart disease
- cancer
- Hep B or C
- HIV
- uncontrolled HTN
What are relative contraindications to kidney living donation?
3 items
- obesity, hyperlipidemia, hx of kidney stones, controlled HTN, substance abuse
- intellectual impairment (unable to give informed consent)
- evidence of coercion or financial reward
What types of surgical options are available for a living kidney donor?
3 items
- laparascopic donor nephrectory
- laparascopic hand-assisted nephrectomy
- open nephrectomy
Complications of an open nephrectomy include…
- atelectasis/pneumonia
- DVT/pulmonary embolis
- UTI
- bowel ileus
- rhabdomyolysis
What does discharge education include for living donor kidney patients?
- no lifting < 10 lbs for 4-6 weeks
- avoid dehydration
- avoid nephrotoxic medications
- return to clinic 2 weeks post-op, and may be released to work at 6-8 weeks
Renal failiure in living donor candidates is…
A. More common than in the general public
B. About as common than the general public
C. Less common than the general public
C
What is the exclusion criteria for living liver donors?
- Age <18 or >60
- BMI >35
- CV, pulmonary, renal disease
- Diabetes
- ongoing malignancy
- local or systemic infection
- severe neurological deficits
- active substance abuse
- untreatable/unstable psychiatric illness
- HIV, HCV, HBsAg positive
In an adult donating a liver to a child, what segment of the donor liver is usually donated?
A. Right Lobe
B. Left Lateral Segment
C. Right Lateral Segment
D. Whole Liver
B
In an adult donating to an adult, what segment of the donor liver is usually donated?
A. Right Lobe
B. Left Lateral Segment
C. Right Lateral Segment
D. Whole Liver
A
A living donor’s liver typically regenerates in what timeframe?
A. 1-4 weeks
B. 1-3 months
C. 3-6 months
D. 6-12 months
D
What are the medical restrictions for living liver donors?
A. No tylenol until LFTs have returned to normal
B. No alcohol until off narcotics and LFTs are normal
C. No other restrictions because the liver regenerates
