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Flashcards in Solid Organ Transplant Deck (18):
1

Uniform anatomical gift act( UAGA)

Created in 1968 is the framework to create a national organ and tissue donation agency stated that it was legal to provide organs and tissues as a gift at time of death

2

National Organ Transplant Act (NOTA)

Called for organ procurement and transplant network(OPTN)
Federal government started to coordinate a more comprehensive national organ transplant system in 1984

3

The united network for organ sharing (UNOS)

Continued work of nota better establishment of organ procurement organizations and gave them geographical locations

4

Strategies to increase organ donation

All hospitals must have an agreement with an opo
The hospital must notify the opo in a timely manner
The opo determines medical suitability for donation
The hospital and the opo must collaborate in family notification and education initiatives

5

Categories of organ donor sources

Living- must be in good health free of diabetes cancer heart and kidney disease and compatible blood type
Deceased- brain death
Deceased after cardiac death(DCD)

6

Determination of brain death

Must have coma, apnea, and abscence of brain stem reflexes
Complete irreversible cessation of brain functioning
Do cerebral angiography, EEG, two physicians with full physical exam
Pt must be normothermic

7

Application of brain death

Abscence of light and corneal reflexes, no dolls eyes, and no cold caloric response, abscence of gag reflex

8

Apnea testing

Don't do if patient is cold or systolic is less than 100 and no evidence of hypoxemia
Take abg take pt off the vent for 8 mins then do another abg paco2 must be 60 or greater

9

Hyper acute graft rejection

Rejection that occurs very rapidly is humoral from previous antibodies that are already in the organism test for antibodies now making this less likely this happens with hrs and causes severe hypoperfusion reaction and organ is cyanotic

10

Graft rejection acute

Occurs in every transplanted patient call mediated rejection never humoral occurs in weeks and months after transplant occurs bc of release of lymphocytes and cytotoxic T cells that are capable of killing invader cells helper T cells up regulate

11

Graft rejection chronic

Combination of humoral antibody and cell mediated rejection characterized by organ becoming fibrotic and results in organ death

12

Induction therapy

Anticipate rejection before the actual transplant
Purpose is to induce tolerance of the transplanted graft

13

Immunosuppressive

Goal is to suppress the activity of helper T cells cocktail for rest of their lives of corticosteroids, calcineurin inhibitors, antimetabolites

14

Liver transplantation indications

Chronic hepatocellular disease
Cholestatic liver disease
Fulminant hepatic failure
Inborn metabolic disorders
Primary hepatic malignancies

15

Immunosuppressant medications side effects

Anemia
Hyperlipemia
Hypertension
Bone disease
Nephrotoxicity
Neurotoxicity
Glucose intolerance
Nausea
Impaired would healing
Hyperuricemia
Hyperkalemia
Hypomagnesia
Infection
Malignancy

16

Post op transplant complications

Rejection
Infection
Acute renal failure
Biliary
Hemorrhage
Htn
Primary non functioning graft
Physiologic

17

Liver transplant criteria

Based on meld score which measures severity
No HLA matching
Based on blood type and size only

18

Immune system management

Constant surveillance
Infection secondary to immune suppression