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Kidney Transplant (Phases (Waiting Period (1-6 year), Transplantation,…
Kidney Transplant
Phases
Waiting Period (1-6 year)
Transplantation
Listing Phase (3-6 months)
UNOS
Post operative care (life of the transplanted kidney)
Education Forum
Medications
Preventive Medicines
Reduce chance of complications from infections
Valcyte, Bactrim, Mycelex, Surfak, Protonix
Antihypertensive
Control blood pressure
Metoprolol, Hydralazine, Clonidine
Immunosuppressants
Lower immune system to prevent rejection
Prograf, Cellcept, Rapamune, Azathioprine, Myfortic, Neoral, Prednisone
Insulin
control blood sugar
Rejection
Acute
Incidence of acute and the time it occurs vary with the therapy used for immunosuppression; Can occur either early or late
Early
occurring within the first 60 days of engraftment;
Late
occurs after the first 60 days; Most episodes of acute occur within the first six months after transplantation, with many such episodes occurring early after surgery
Chronic
Most prevalent cause of RF; Presents by chronic transplant dysfunction; Characterized by increasing in creatinine, in combination with proteinuria and hypertension; Result of chronic calcineurin inhibitor nephrotoxicity
#
Drugs that increase calcineurin inhibitor concentrations
:red_flag: Calcium channel blockers :red_cross: Antifungal agents :red_flag: Antibiotics :red_cross: Antigout agent :red_flag: Antidysrhythmic :red_cross: Dopamine receptor agonist :red_flag: H2 receptor antagonists :red_cross: Androgen :red_flag: Cholinergic :red_cross: Oral contraceptive
Hyperacute (antibody mediated rejection)
Very rapid onset; Occurs in the OR, hours to days after transplant; Attack is typically directed at the vasculature of the graft; Transplanted kidney becomes grossly mottled and cyanotic; believed to be due to preform antibodies reactive against donor antigens; Kidney never function and the patient returns to dialysis
WHICH
organ or tissue can be donated? Organs- Kidney, Heart, Pancreas, Liver, Lungs, Small intestine. Tissue- Corneas, Skin, Heart valves, Bone, Bone marrow, Vein, Tendons, Cartilage, Ligaments, Fascia, Dura.
HOW
frequently are candidates on transplant list reevaluated? Require periodic yearly reevaluation and are performed in order to 4 D's :arrow_right: 1) Document the continued need for transplant 2) Determine the progression of the end stage disease and make treatment modifications as necessary 3) Determine the progression of any co-morbid conditions 4) Determine the development of any new disease
WHO
can be considered an organ and tissue donor? Anyone except HIV positive and extra cerebral malignancies are not considered or accepted
WHAT
organs can be transplanted from a living donor? are the different types of donation? Kidney and Liver. Direct donation, Paired exchange donation, Good samaritan donation (Altruistic)
Contraindications
Disseminated malignancies, Untreated cardiac disease, Chronic respiratory failure, Extensive vascular disease, Chronic infection, Unresolved psychosocial disorder