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Renal Transplant 2 - Coggle Diagram
Renal Transplant 2
OSCE
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What meds and why
Immunsuppressive agents
Non HLA identical - rejection
Allo-immune response - inate and adaptive immunity
Types of rejection
- T cell mediated
- Antibody-mediated
- Mixed
Acute and / or chronic
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AKI in Transplanted Pt
Formulate ddx for AKI
PRe-renal, renal, post renal
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Work up
Renal imaging
Urine C and S
Urinalysis
Screen for anti-GBM disease and ANCA
Quantify proteinuria
Urine microscopy (ATN)
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Live Donation Safety
- Peri-operative / surgical risks
Similar to age-matched non-donors and in some studies slightly reduced
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Epidemiology
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Overall p[revealence of undiagnosed CKD hi in early stageds when effective mx could be initiated to slow / avert progression
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Transplant vs Dialysis
Transplant
- Improved QoL
- improved morbidity
- Improved mortality
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The best kidney
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Expanded criteria donor
- Older >50
- +/- hypertension
- +/- hx of cva
- +/- baseline midly elevated creatine
KDIGO Guidelines
Access to Transplant
- All pts expected to reach end stage
- Refer 6-12months before anticipated dialysis
- PRe-emptive transplant with living kidney donor
Affords superior survival and QoL at lower cost to Dialsysi
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