Transplant surgery Flashcards
(31 cards)
Liver MELD cutoff?
> 20
when to consider TIPS instead of transplant?
MELD <18
post op complications of liver transplant?
thrombosis, PV thrombosis, Leak, graft failure
post op labs to monitor in liver transplant?
bilirubin, lactate, transaminases
Lab value to be elevated if concerned for rejection?
lactate
Hepatic artery thrombosis post transplant management? 2nd line? 3rd?
perc angio with stent/thrombectomy/retransplant
absolute CI to donor heart?
MI, CAD, hypokinesis, ventricular arrythmia, CO poisoning, metastatic CA
CI to heart retransplantation?
ECMO bridge
Post transplant lymphoproliferative disease?
B cell lymphoma induced by EBV- will have increased LDH and monoclonal spike, PET positive
prevention of CMV with donor CMV positive?
tx with ganciclovir and CMV Ig
immediate complications post LT?
PGD, volume overload, anastomotic issues
PGD timing?
hours to 3 days
MOA of PGD?
ischemia reperfusion
PGD sx?
new infiltrates, decreased complaince, inc PVR, poor gas exchange
tx for PGD?
diuretics LPV, possible ECMO
oncologic CI to transplant?
history of melanoma or active malignancy
post pneumonectomy BP fistula mgmt?
if acute and large >5mm needs reexploration
chornic ones with empyema consider OWT
if small consider bronchoscopic interventions
if after lobectomy consider a pneumonectomy
C4D staining seen in what? tx?
ab mediated rejection, IVIG
post transplant lymphoproliferative disorder? tx?
HSM, fever, generalized lymphadenopathy caused by EBV
reduce immunosuppression and give rituximab
CMV infection post transplant presentation?
diarrhea and hepatits
polyoma BK virus presentation?
increased Cr, interstitial nephritis
post lung transplant with new stroke and infiltrates?
pulmonary vein thrombosis
treatment for pulmonary vein thrombosis?
AC or thrombolysis
MC complication in iniital post op lung transplant period?
PGD
