Mod13: Anesthesia for Organ Transplantation Flashcards Preview

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Flashcards in Mod13: Anesthesia for Organ Transplantation Deck (25)
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1
Q

Anesthesia for Organ Transplantation

Which organization coordinates all the nation’s organ transplant systems?

A

UNOS

United Network for Organ Sharing

They meet the needs of persons waiting for a life saving organ tpx

Non-profit; based in Richmond, VA

Members are every tpx hospital, tissue matching lab, Organ procurement organization

All data are centrally located - Allows to quickly match available organs to recepients

Minimizes time from procurement to transplantation; this decreases post tranplant morbidity and mortality

2
Q

Anesthesia for Organ Transplantation - Organs

What is the only organ that cannot be functionally supported or replaced, and therefor cannot be transplanted at this time?

A

The brain

3
Q

Anesthesia for Organ Transplantation - Organs

True or False - All vital organs: Heart, Lung, Liver and Kidney, can be supported by technology or replaced by transplantation; except the brain.

A

True

4
Q

Anesthesia for Organ Transplantation - Transplantation

Which areas of transplantation surgery are the most affected by the quality of the anesthetic management?

A

Quality of the graft organ

Viability of the transplanted graft

Long term survival of the transplant recipient

Become familiar with not only what you should be doing during a normal kidney tpx (for example), but also what’s expected from the surgical team and from the anesthesia team at that institution

5
Q

Anesthesia for Organ Transplantation - Transplantation

True or False: Training in organ transplantation is imperative

A

True

Training and becoming familiar with what’s expected of you will help that initial management

You could stay up to date on what some of the newer techniques are. If your protocol starts to change, you will know why

You will see improved outcome, the more comfortable you are as an anesthesia provider in doing those types of cases

6
Q

Anesthesia for Organ Transplantation - Transplantation

True or False: According to data from UNOS, the number of organs being transplanted is increasing

A

True

7
Q

Anesthesia for Organ Transplantation - Transplantation

Which thoracic organs may be transplanted?

A

Heart (from a deceased donor)

Lung (from a deceased or living donor)

Heart & Lung (from a deceased donor)

8
Q

Anesthesia for Organ Transplantation - Transplantation

Which abdominal organs may be transplanted?

A

Kidney (from a deceased or living donor)

Liver (from a deceased donor, or living donor for partial liver)

Kidney & Liver (from a deceased donor)

Pancreas (from a deceased donor only)

Intestine (from a deceased donor only)

9
Q

Anesthesia for Organ Transplantation - Transplantation

Besides thoracic and abdominal organs, which other body structures may be transplanted?

A

Tissue, cells, corneas, stem cells, bone marrow

There are many different transplants happening now

As technonology gets better, we will see even more types or combined transplants occuring

10
Q

Anesthesia for Organ Transplantation - Transplantation

How many organs were transplanted from 1988 to 2015?

A

500,000

11
Q

Anesthesia for Organ Transplantation - Transplantation

Number of Transplantations from the highest to lowest

A

Kidney>Liver>Heart>Lung>Kidney+Pancreas>Pancreas>Intestine>Heart+Lung

12
Q

Anesthesia for Organ Transplantation - Transplantation

What’s the major organ the most transplanted?

A

Kidney

13
Q

Anesthesia for Organ Transplantation - Transplantation

What is the most transplanted body structure?

A

Cornea

14
Q

Organ Transplantation

How much does an organ transplant cost?

A

Isolated Small Bowel Transplant - $350,000

Heart/Lung - $300,000 to $350,000

Heart - $300,000

Bone Marrow - $250,000

Liver - $250,000

Lung - $200,000 to $250,000

Kidney/Pancreas - $150,000

Pancreas - $100,000

Kidney - $75,000 to $100,000

15
Q

Organ Transplantation

What is most perfected organ transplant? and how much does it cost?

A

Kidney - $75,000 to $100,000

16
Q

Organ Transplantation

Which factors add to the cost of a normal organ transplant?

A

Complications resulting in longer hospital stay

Pre or Post tpx follow up and Tx

17
Q

Organ Transplantation

Which comorbidities might be valid reasons not to transplant?

A

Advanced heart, kidney or liver disease

HIV infection

Cancer

Hepatitis B

Hepatits C with proven cirrhosis by liver biopsy

18
Q

Organ Transplantation

True or False: Current substance abuse: alcohol and illicit drugs might be valid reasons not to transplant?

A

True

If they don’t plan on stopping in the future

19
Q

Organ Transplantation

True or False: Advanced heart, kidney or liver disease might be a valid reason not to transplant

A

True

20
Q

Organ Transplantation

True or False: HIV infection might be a valid reason not to transplant

A

True

21
Q

Organ Transplantation

True or False: Cancer might be a valid reason not to transplant

A

True

22
Q

Organ Transplantation

True or False: Hepatitis B might be a valid reason not to transplant

A

True

23
Q

Organ Transplantation

True or False: Hepatits C without proven cirrhosis by liver biopsy might be a valid reason not to transplant

A

False

Hepatits C with proven cirrhosis by liver biopsy

24
Q

Organ Transplantation

Why might the lack of social support be a valid reason not to transplant?

A

Associated with compliance issues

Associated with inability to carry out the responsibilities necessary to maintain a healthy lifestyle and remain compliant with all medications

25
Q

Organ Transplantation - Candidacy for Transplantation

What 3 Goals are we looking for when identifying a candidate for transplantation?

A

Transplant is indicated (will be on the transplant list)

Absence of comorbidities that preclude transplant

Presence of Emotional and social resources that permit major surgery and rehab => a/w Compliance

Must be prepared to take antirejection meds daily for life