27. Transplant

Question 1

how much longer do patients with transplant survive than patients on dialysis?

Answer 1

30% lonver.

diabetics have shorter survival in general

Question 2

what is the population of patients who generally gets ESRD?

Answer 2

45-64 yrs, 55% caucasian, diabetic nephropathy or HTN

Question 3

without one type of cell, you will not reject any organ: what is that cell type?

Answer 3

T cells

Question 4

what are the most important HLAs for determining compatibility?

Answer 4

HLAs A, B, DR

Question 5

what does calcineurin do?

Answer 5

once T cell recognizes a foreign antigen, calcineurin upregulates nuclear ten of T cell receptors

Question 6

what is the most important phase to the graft rejection process (if you could block this, you could stop rejection)

Answer 6

Signal 3: the effector phase. the graft is infiltrated, massive inflammation and apoptosis

Question 7

what are two calcineurin inhibitors?

Answer 7

cyclosporine (CSA) and tacrolimus (FK506)

Question 8

what is the biggest side effect of tacrolimus?

Answer 8

diabetetogenic (20%)

Question 9

Other side effects of tacrolimus?

Answer 9

HTN, nephrotoxicity, neurotoxocity, possible hyperlipidemia

Question 10

what are some side effects of cyclosporine (CSA)?

Answer 10

diabetogenic (less than tacro), gingival hyperplasia, hirsituism, hyperlipidemia, HTN, nephrotox