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Flashcards in Transplantation 2 Deck (17)
1

Rejection within minutes

Hyperacute

2

What is acute rejection?

Early rejection, T cell or B cell mediated response
-Can be treated with increased immunosuppression

3

Name 2 calcineurin inhibitors

Cyclosporin, tacrolimus

4

How do calcineurin inhibitors work?

Inhibit activation of T helper cells (NK cells, cytotoxic cells, decrease cytokine release - prevent B cell proliferation)

5

Side effects of calcineurin inibitors

Renal dysfunction
Hypertension
Diabetes
Tremors

6

What is chronic reaction?

Antibody-mediated vascular damage (months to years, controversial)

7

How do azathioprine and mycophenalate work?

Suppression of proliferation of B cells (block purine synthesis)

8

Side effects of azathioprine and mycophenolate?

Leucopaenia Anaemia
GI side effects

9

Leucopaenia
Anaemia
GI side effects

Azathioprine and mycophenolate

10

Renal dysfunction
Hypertension
Diabetes
Tremors

Calcineurin inhibitors

11

How do steroids work?

Suppress activity of T cells
Suppress proliferation of B cells

12

Is vasculitis a contra-indication to kidney transplant?

Active vasculitis is a contra-indication

13

Absolute contraindications to kidney transplant

Malignancy
Known untreated malignancy
Hx of solid tumour within 2 years (For some tumours 5 years)
Untreated TB
Severe IHD not amenable to surgery (should be carried out prior to Tx)
Severe airways disease
Active vasculitis
Severe PVD (Unusable vessels)

14

What is the surgery like for kidney transplantation?

procedure
Usually 3-4 Hours
Stent inserted between ureter and bladder
Wound 15-20 cm long

15

Surgical complications

Bleeding (arterial or venous)
Arterial Stenosis / Thrombosis
Venous stenosis / Thrombosis
Ureteric Stricture and hydronephrosis
Wound infection

16

How to tell if the graft is working

The urine output will be good and the creatinine will fall

17

What is delayed graft function?

You develop acute tubular necrosis after transplant
You will need haemodialysis for a bit
BUT your transplant will work 10-30 days after