Organ transplant Flashcards

(33 cards)

1
Q

What is a heterograft?

A

transplantation of tissues between two different species

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2
Q

What is an isograft?

A

transplantation of tissues between identical twins

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3
Q

What is an allograft?

A

tissue that is transplanted between members of the same species

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4
Q

What are the 3 topics that need to be assessed in order to determine brain death?

A

ensure the cause of unresponsiveness is not reversible
absence of metabolic central nervous system depression (which must be fixed first)
Absence of toxic cns depression (sedatives, alcohol, neuromuscular blockade)

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5
Q

Can an EEG be used to determine brain death?

A

no

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6
Q

If a person has brain death, will they be positive or negative for the doll’s eye test?

A

negative

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7
Q

What criteria need to be met in order for a person to be a donor?

A

no active bacterial, viral, or severe fungal infections
No active systemic cancers
Assessment of high risk behaviors (IV drug use, etc.)
Absence of hyper/hypotension
Diabetes may or may not be an issue
Corneas less stringent (avascular)

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8
Q

What are the 5 major goals for physiologic management of a donor?

A

maintain hemodynamic stability
maintain optimal oxygenation
maintain normothermia
maintain fluid and electrolyte balance
prevent infectiosn

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9
Q

What is the golden hour for organ donation?

A

the organs must be procured from the donor within an hour after the death of the patient

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10
Q

Which hospitals in arizona perform organ transplants?

A

banner UMC (Tucson)
Mayo clinic (Scottsdale)
St. Joe’s (Phx)
AZ GS Banner UMC

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11
Q

When can an organ be re-transplanted?

A

if the original recipient died from something other than transplant related

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12
Q

How long can a heart be out of a body and on ice before it must be transplanted?

A

4-6 hours

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13
Q

What is different about an ECG for a patient that has had a heart transplant?

A

it will have 2 p waves

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14
Q

What is one of the major complications of receiving a denervated donor heart?

A

The patient may not experience angina, and since they cannot feel pain, the patient may have silent MIs

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15
Q

What are common signs and symptoms of a heart transplant rejection?

A

fatigue/weakness
fever 100.5 or greater
General malaise
SOB
Tachycardia/dysrhythmia
Edema/sudden weight gain
Hypotension

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16
Q

What is a major sign that rejection of a heart transplant is occurring?

17
Q

What are the clinical indications for a lung transplant?

A

irreversible end stage lung disease, expected to die in 1-2 years

18
Q

Why would a patient need a single lung transplant?

A

COPD, Alpha-1 Antitrypsin Deficiency

19
Q

Why would a patient need a double lung transplant?

A

CF or bronchiectasis

20
Q

why would a patient need a heart/lung transplant?

A

pulmonary HTN or Elsenmenger’s

21
Q

What is the cold time for a lung transplant?

22
Q

What are the common signs/symptoms of rejection?

A

Malaise
Non-productive cough
Dyspnea
Decreased O2 sats
Abnormal pulmonary function test

23
Q

Indications for a liver transplant

A

Primary Biliary Cirrhosis
Other Cirrhosis (non-alcoholic)
Post necrotic, Cryptogenic, TPN induced, Laennec’s
Alcoholic Liver Disease
Chronic Active Hepatitis
Hepatocellular Cancer
Biliary Atresia

24
Q

What is the cold time for a liver transplant?

A

less than 12 hours

25
What is the cold time for a kidney transplant?
less than 30 hours
26
What is the test used for kidney rejection diagnosis?
ultrasound or biopsy
27
When is a kidney/pancreas transplant indicated?
type I diabetes
28
When does hyperacute rejection occur?
immediately in the post-op period
29
What needs to be done if a hyperacute rejection occurs?
re-transplant or life sustaining treatment
30
When does acute rejection occur?
1st 3-6 months after transplant
31
What happens with chronic organ transplant rejection?
Chronic inflammation with diffuse scarring and stenosis of the vasculature of the organ This causes lack of blood supply and ischemia to the organ
32
Side effects of long term corticosteroid use
increase in blood sugar, weight gain (increase in appetite), bone disorders (softening), moon face, vision changes, stomach irritation, etc
33
What is the life-long triple therapy that transplant patients do?
CSA, Tracrolimus or Rapamune Prednisone Imuran or Cellcept