Kidney and Liver Transplant Flashcards
What are the most common causes of end-stage renal disease?
- Diabetes
- Hypertension
- Glomerulonephritis
Kidney donor and recipients must have the same what? (hint: molecule)
HLA - human leukocyte antigen
What is known as a transplant that is placed in the same anatomic location as the native organ?
Orthotopic
In adults, where are renal transplants usually placed?
Rt iliac fossa
What is another term for a renal transplant from a deceased donor?
“Carrel patch” - the RA and a section of the Ao is anastomosed to the recipients EIA
What creates a higher chance of thrombosis in renal transplantation? A transplant from a living or deceased donor?
LIVING - because the anastomosis is smaller
What is an En-bloc transplant/what does the recipient receive?
Recipient will receive both kidneys, both ureters, both renal arteries with a section of the suprarenal AO and both renal veins with a section of the infrarenal IVC
SF of a transplanted kidney?
- Superficial and run with the axis of the incision site
- Hilum oriented inferior and posterior
T or F? A native kidney is typically smaller than a transplanted kidney?
TRUE
What is the normal RI of a transplanted kidney?
0.6-0.7
What 3 parameters would conclude a normal transplanted kidney?
- Low resistance waveform
- Sharp systolic upstroke with forward end-diastolic flow
- RI <0.7
What is the most common cause of graft loss in a renal transplant?
Rejection
What are the 3 types of rejection?
- Hyper-acute - Occurs minutes to hours after
- Acute - Occurs 2 weeks to 3 months. RI > 0.8
- Chronic - Gradual deterioration beginning 3 months after
What is ATN (acute tubular necrosis) caused by?
Cold ischemic time
What is known as the “time between chilling of organ after blood supply has been cut off and when it is warmed by having its blood supply restored” ?
Cold ischemic time
Is ATN more common in living or deceased donors?
Deceased
T or F? ATN is a sign of rejection?
FALSE
When does acute tubular necrosis typically occur?
Day 2 or 3 after operation
What substance may remain high, making it difficult to distinguish between ATN & rejection?
Creatinine
What is known as “hypertension secondary to extrinsic compression of the kidney by a subcapsular collection/hematoma”?
Page kidney
A hematoma after kidney transplant is typically seen in which pole of the kidney?
Lower pole
What are the different fluid collections seen in a kidney transplant?
- Hematoma - found immediately post-op
- Urinoma - suspected if urine output decreases but kidney is functioning normally
- Lymphocele - pseudo-cysts filled with lymph and has a hard fibrous capsule - SF will show septations within the cyst
T or F? Mild pelvocaliectasis is a normal finding in a transplanted kidney?
TRUE
Is renal artery thrombosis (RAT) more common in adult or peds with renal transplants?
Peds