Organ Procurement and Allocation
Which organ is most often transplanted? Which organ is least often transplanted?
Kidney is the most often transplanted
Intestines are least often transplanted
Why would it be stressful to be a candidate for a transplant?
Recipient could die waiting, someone else has to die for them to live
What transplant has the highest survival rate? What transplant as the lowest survival rate?
Kidney- 97% 1 year survival, 86% 5 year survival
Intestines- 82% 1 year survival, 59% 5 year survival
Describe the organ procurement and distribution system. Which organizations keep track of transplant candidates in the U.S?
UNOS (United Network for Organ Sharing) keeps a national waiting list
There are 11 regions in the US and each area has an organ procurement organization (OPO)
What biopsychosocial issues affect organ recipients?
Anxiety, legal/ethical considerations
Pre transplant: declining status, uncertainty, medical expenses, waiting period
Post-transplant: long recovery, potential rejection, lifelong changes, post-op complications, side effects of meds
What happens for a donor to be able to donate their organs? What are some qualifications they have to meet?
Brain death (not coma)
No evidence of cancer or sepsis (Hep B or C)
Body weight limits
Donor organ testing
Explain the complications that can occur after organ transplant.
Ischemic reperfusion injury, incompatibility, acute and chronic rejection, immunosuppression
How is an organ recipient matched with a donor?
Patient is listed at the transplant center (after eval)
Classified by UNOS: (blood type, body weight, medical urgency, age, time on waiting list, co-morbidities, chance of survival)
Medical compatibility of donor and recipient, preference given to people at top of list
Why does immunosuppression lead to complications?
Immunosuppression is the leading cause of death in transplant recipients
- infection due to immunosuppression
- graft rejection (immunologic)
What are the different viability times for different organs?
Heart- up to 6 hours
Lung- up to 8 hours
Liver- up to 12 hours
Intestines- up to 16 hours
Pancreas- up to 18 hours
Kidney- up to 36 hours
Explain the importance of physical activity for transplant candidates (pre transplant) and transplant recipients.
Pre transplant need for exercise: these people are deconditioned 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 effect, return to work, safely participate in sports and exercise