Organ Transplant Flashcards
criteria for organ transplant
- end-stage disease
- failure of conventual therapy to treat condition
- absence of untreatable malignancy or irreversible infection
- absence of disease that would attack transplanted organ
what must candidates do to be eligible for an organ transplant?
- demonstrate emotional and psychological stability
- have an adequate support system
- be willing to comply w/ lifelong immunosuppressive drug therapy
how long is a heart viable?
4-6 hours
how long are lungs viable?
4-6 hours
how long is a pancreas viable?
24 hours
how long is a liver viable?
24-30 hours
how long are kidneys viable?
48-72 hours
Chronic diseases pre-operatively lead to what?
- muscle weakness
- prolonged hospitalization
- prolonged bed rest
- fatigue
- poor breathing mechanics
- poor gait skills
what is hyperacute rejection? When does it occur?
- occurs within 48 hours of transplant surgery
- graft becomes nonfunctional, usually due to ABO blood group or human leukocyte antigen
- unresponsive to treatment
What is acute rejection? When does it occur?
adaptive response involving T cells
- may occur within 3 months to 1 year post-op
- treatable
What is chronic rejection? When does it occur?
antibody mediated process involving T and B lymphocytes
- occurs within a few months post-op
- gradual and progressive deterioration of graft that requires another transplant
Acute vs Chronic graft vs host disease (GVHD)
acute - donor T cells responding to mismatched host antigens
chronic - autoimmune diseases
What is graft vs host disease? How is it different than transplant rejection?
GVHD - donors immune cells causing recipient organ rejection
transplant rejection - recipient immune response rejects the donor’s organ
What does Acute GVHD cause?
cytokine storm = mass inflammation
general S&S of infection
- temp > 100.5
- shaking, chills, body aches
- sweating
- diarrhea lasting longer than 2 days
- dyspnea
- cough or sore throat
basic eval components of organ transplant (8)
- vitals
- ROM/strength
- integumentary assessment
- posture assessment
- pulmonary assessment
- endurance/activity tolerance
- functional mobility
- preparing for D/C
S&S of graft vs host disease
- abdominal pain, N/V/D
- skin rash
- specific to organ
S&S of organ rejection
- flu-like symptoms
- fever > 101
- pain over tranplant
- fatigue
- specific to organ
What should MAP be for adequate perfusion to organs?
> 60-70 mmHg
what are interventions for organ transplant patients?
- focus on impaired gas exchange
- airway clearance
- positioning
- therex
- transfer training
- gait training
What outcome measure is good for heart and lung transplant?
6 MWT
What outcome measure is good for kidney transplant patients?
sit to stand
