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MAP II Final > Heart & Lung Transplant Rehab. > Flashcards

Heart & Lung Transplant Rehab. Flashcards

1
Q

What is most transplanted organ?

A

Kidney.

Followed by liver

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2
Q

What does the OPO (organ procurement organization) do?

A

identifies, evaluates, and maintains donor

-including obtaining consent.

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3
Q

Can the physician of the donor or the physician that pronounces death be involved in the transplant?

A

NO

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4
Q

How long does transplant center have to decide after organ is offered?

A

1 hr

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5
Q

how many hrs are there between organ harvesting and transplantation?

A

6-8 hrs

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6
Q

What are the cardinal signs of brain death that a donor must show

A

Coma/unresponsive

  • absnece of motor responses to pain
  • absence of brain stem reflexes
  • apnea
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7
Q

what is the transplant process ?

A
  1. Deceased donor
  2. OPO
  3. UNOS (United network of organ sharing - computer system)
  4. transplant center
  5. candidates
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8
Q

Organs must be matched on?

A
  • tissue type
  • blood type
  • length of time on waiting list
  • immune status/antigens
  • distance between recipient and donor
  • degree of medical urgency
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9
Q

What are the 3 ethical considerations? and what do they involve?
Which is prioritized?

A
  1. Utility
    - maximize benefit to all
    - consider survival and QOL
  2. Justice/equity** (prioritized)
    - fair distribution
    - sicker 1st
  3. respect for persons
    - right not to donate
    - transparency
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10
Q

Heart transplant donor criteria

A

-normal EKG
No HIV or hepatitis
-brain death declare
-age

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11
Q

Heart transplant recipient criteria

A
  • terminal heart disease
  • no renal/hepatic dysfunction
  • no acute infections
  • no recurrent pulmonary infections
  • psychosocial stability
  • no alcohol, drug, tobacco use
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12
Q

Pre transplant rehab?

A

maximize candidates strength and endurance to activity

-closely monitor HR, BP, 02 st, dyspnea

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13
Q

Early complications Post transplant

A
  • donor organ dysfunction
  • acute rejection
  • retail failure
  • arrhythmia
  • bleeding
  • infection due to immunosuppression
  • denervated heart physiology
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14
Q

What occurs in Acute rejection?

A
  • all recipients reject organ to some degree
    1. organ function starts to decrease
    2. general discomfort, uneasiness, ill feeling
    3. pain/swelling in organ area
    4. fever/flu like symptoms
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15
Q

What is infection due to immunosuppression?

A
  • caregivers must wear masks
  • must take anti rejection meds for life
  • Glucocorticoids (prednisone) suppress body’s natural immune system
  • steriod myopathy: damdage to mm tissue - weakness
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16
Q

What percentage of heart transplants is due to coronary artery disease/ischemic heart disease?

A

44.8%

17
Q

Orthotopic heart transplants

A

patient’s heart replaced by donor’s heart

18
Q

Heterotopic heart transplants

A

donor’s heart placed next to recipient’s heart

19
Q

Chronic complications post-transplant

A

a. prone to infection due to immunosuppression
b. accelerated CAD
c. chronic rejection (greatest risk within first year)
d. HTN
e. malignancy

20
Q

Pre-transplantation rehab maximizes what?

A

cardiac rehab maximizes candidate’s strength & endurance

21
Q

Post-transplantation rehab focuses on what?

A

Focus on functional mobility:

    • sternal precautions
    • phase 1 cardiac rehab
    • abnormal HR responses
22
Q

Special considerations with exercise?

A
    • denervation: loss of vagal tone, lack of SNS stimulation
    • patient may not have chest pain during exercise
    • patient will have higher resting HR which will only increase with exertion (>100 bom)
    • altered baroreceptor response: HR increases slowly with exercise and then remains elevated for increased time post-exercise
    • signals from aortic baroreceptors normally travel thru vagus nerve (upon sitting/standing, BP will drop –> without baroreceptors there will be a poor readjustment to normal BP
23
Q

Ventricular assisted device (VAD) is used in what kind of patients?

A

patients with non-reversible left ventricular failure at imminent risk for death

24
Q

Function of VAD?

A
    • a mechanical pump used to support heart function and blood flow in people with weak or failing hearts.
    • 2 chamber unit made of titanium: blood chamber and chamber for electric motor
    • The device is implanted in the left upper quadrant of the abdomen and pumps blood from the lower chambers of the heart to the rest of the body.
    • bridges the gap between terminal heart disease & heart transplant

MAP II Final (9 decks)

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