Kidney
what is an allograft vs. autologous vs. xenogenic
allograft: person to another person
autologous: within the same person (tissue to another area)
xenogenic: different species to human (pig valve)
what is overall prognosis for transplants
survival > 5 years, 93% good health, 89% return to work
what is immunosuppression and why is it such an issue
immunosuppressants are necessary for transplantation to lower the bodies reaction and potential rejection to new organ. However, immunosuppressants increase risk of certain cancers, DM, HTN, impair wound healing, and cause GI complications
what are some post transplant implications
long recovery, potential rejection, lifelong changes, post-op complications, side effects of meds
What are the requirements for donors
Brain death (not coma), no evidence of cancer or sepsis (Hep B or C), body weight limits, donor organ testing
what are primary reasons for mortality posttransplants
infection (from immunosuppression) and rejection
List some research advances
immunosuppressive med have fewer adverse effects, xenotransplantation (from another animal e.g. pig valve), tissue engineering and regenerative medicine, Ventricular assist device (VAD), ECMO (extracorporeal membrane oxygenation), dialysis
what is the viability (in hours) for the following organs:
heart, lung, liver, intestines, pancreas, kidney
heart: 6 hrs
lung: 8 hrs
liver: 12 hrs
intestines: 16 hrs
pancreas: 18 hrs
kidney: 36 hrs
which transplants can be combined? (hint: there are 3)
kidney-heart, liver-lung, pancreas-intestine
How does the UNOS classify recipients
Blood type, body sz/wt, medical urgency, age, time on waiting list, co morbidities, chance of survival, medical compatibility of donor and recipient, preference given to candidates at top of list in geographic area (local, then national)
what are some pre-transplant implications
declining status, uncertainty, medical expenses, waiting period
what is the UNOS and how many regions are contained in it
what are pt implications of transplantation
pre-transplantation: need for exercise - deconditioned state from failing organ, decreased exercise tolerance, DOE, fatigue
post-transplant need for exercise - recipients can progressively return to "normal" activity level, monitor vitals, effects of denervation, med effects, return to work, safely participate in sports and exercise (reintegration back to quality life)
list the organs in order from highest survival rate to least
Kidney > pancreas > heart > liver > lung > intestine
What are donor choice laws
Your wishes carried out at your death: by dept. motor vehicles on DL, donor website, your personal legal documents, family consent
what are potential complications of transplantation
ischemic reperfusion injury, incompatibility, acute and chronic graft rejection, immunosuppression
what is the leading cause of death in transplant recipients
immunosuppression - infection due to immunosuppression, graft rejection