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Small Parts/specialized > Chapter 20 Transplant > Flashcards

Chapter 20 Transplant Flashcards

1
Q

The most common reason for liver transplant in US

A

Cirrhosis, due to chronic hep C and alcohol abuse

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2
Q

Scoring system for assessing the severity of chronic liver disease

A

MELD— Model for End-stage Liver Disease

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3
Q

Cadaveric liver donation connections:

A

-pretty much the same connections as the native liver

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4
Q

Living donor donation usually donates the ___ lobe

A

Right

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5
Q

The _________ are not routinely included in the native liver exam, but they are very important to image in transplanted patient

A

Hepatic arteries

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6
Q

A low RI can indicate

A

Proximal stenosis

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7
Q

High RI can indicate:

A

Rejection or hepatic venous congestion

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8
Q

Hepatic artery flow through out diastole: _____ resistance

A

Low resistance

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9
Q

Hepatic arteries velocities should be below:

A

200 cm/s

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10
Q

A normal RI in the hepatic artery is:

A

.5-.7

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11
Q

The most common cause for liver transplant failure is _____

A

Rejection

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12
Q

Acute rejection occurs within the first _____

A

10 days

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13
Q

Thrombosis and stenosis most commonly occurs at the ____ sites

A

Anastomosis sites

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14
Q

Hepatic vein/IVC thrombosis and stenosis color Doppler will show:

A

Aliasing, turbulence, tripling of the spectral Doppler waveform

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15
Q

Hepatic artery stenosis: ______ waveform

A

Tardus parvus

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16
Q

Hepatic artery stenosis velocity:

A

Greater than 200 cm/s

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17
Q

Hepatic artery stenosis RI:

A

Less than .5

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18
Q

The most common vascular complication of liver transplantation is:

A

Hepatic artery(HA) thrombosis

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19
Q

_____ is the only vascular supply to the bile ducts

A

Hepatic artery (HA)

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20
Q

Biliary complications usually occur within the first ______ months after transplantation

A

3 months

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21
Q

Most common biliary complication:

A

Obstruction

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22
Q

Hematomas are most common along the ____ spaces near the vascular and biliary anastomoses sites

A

Perihepatic

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23
Q

Recurrence of HCC is seen in about ___% of patients after their liver transplant

A

40%

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24
Q

The most common site of HCC recurrence is:

A

Lung, and then the liver

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25
Q

Portal venous gas is a common finding on ultrasound during the _____ period following transplantation

A

Early postoperative

26
Q

Post-Transplant Lymphoproliferative Disorder appears:

A

hypoechoic soft tissue mass and may encase hepatic hilum

27
Q

Transjugular Intrahepatic Portal-Systemic Shunt(TIPS) is placed:

A

Between right hepatic vein and right portal vein

28
Q

A widely patant TIPS, the RPV and LPV will demonstrate _____- flow

A

hepatofugal

29
Q

TIPS is placed by using ____ access

A

Jugular

30
Q

TIPS is placed to:

A

Lower portal pressure(portal HTN)

31
Q

TIPS malfunction: velocity

A

<50cm/s or >190cm/s

32
Q

TIPS malfunction: _____ flow of LPV or RPV

A

Hepatopetal

33
Q

The most common cause for needing a renal transplant is:

A

chronic end-stage renal disease or renal failure

34
Q

Most common cause of renal disease leading to kidney transplant

A

Diabetes

35
Q

Renal transplant is usually placed into the:

A

Right iliac fossa

36
Q

In cadaveric renal transplants, the donors MAIN RENAL ARTERY is harvested with a portion of the AORTA which is then anastomosed to:

A

The side of recipient external iliac artery

37
Q

Live donor transplants involve a direct anastomosis of _____ to the _______

A

Renal arterial graft to the external or internal iliac artery

38
Q

The main renal vein is almost always grafted to the recipient ______ in a ___ to side manner

A

External iliac vein in an end to side manner

39
Q

Renal: low RI indicates

A

Proximal stenosis

40
Q

Renal: high RI indicates

A

Rejection, renal venous congestion

41
Q

Normal renal transplant sonographic findings: ______ flow

A

Continuous diastolic flow

42
Q

Normal renal transplant sonographic findings: _____ resistance wave form

A

Low resistance

43
Q

Normal renal transplant sonographic findings: velocities should be:

A

Below 250cm/s

44
Q

Normal renal transplant sonographic findings: RI in the arcuate artery:

A

.6-.7

45
Q

Most common biopsy complication:

A

Bleeding

46
Q

Causes of draft dysfunction or failure(renal):

A
  • rejection
  • acute tubular necrosis
  • pyelonephritis
  • drug nephrotoxicity
47
Q

Renal graft dysfunction/failure: pyelonephritis occurs in ___% of patients in the first year

A

80%

48
Q

The most common complications immediately postoperative and within the first year of transplantation are: _______ and ______

A
  • Acute rejection

- Acute Tubular Necrosis

49
Q

Renal graft complications: arterial flow RI:

A

> .8

50
Q

In early stages following transplantation, the most common cause of hypertension is ______

A

Acute rejection

51
Q

Urinary obstruction & stones: The most common site of obstruction is—

A

At the site of ureteral implantation into the bladder

52
Q

(Renal) echogenic foci with shadowing or “twinkle” artifact on color Doppler:

A

Stones

53
Q

Early ultrasound findings of renal vein stenosis and thrombosis:

A

Renal enlargement, hypoechoic cortex(edema)

54
Q

Late ultrasound findings of renal vein stenosis and thrombosis:

A

-decreasing size and increased echogenicity

55
Q

Renal artery thrombosis or stenosis: peak systolic velocity:

A

Greater than or equal to 250cm/s

56
Q

Renal artery thrombosis or stenosis: velocity difference between pre and post stenotic segments ____

A

2:1

57
Q

Renal artery thrombosis or stenosis: _____ waveform distal to stenosis

A

Tardus parvus

58
Q

Renal artery thrombosis or stenosis: Renal artery/Aorta Ratio(RAR)

A

> 3.5

59
Q

Most common peri-transplant fluid collection

A

Lymphoceles

60
Q

Lymphoceles are typically found ____ to the transplant

A

Medial

61
Q

Most common fluid collection that causes hydronephrosis

A

Lymphocele

62
Q

Most severe complication found in solid organ as well as stem cell transplantation:

A

Post-Transplant Lymphoproliferative Disorder(PTLD)

Small Parts/specialized (15 decks)

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