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NURS 470 > Organ transplant > Flashcards

Organ transplant Flashcards

1
Q

What is a heterograft?

A

transplantation of tissues between two different species

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2
Q

What is an isograft?

A

transplantation of tissues between identical twins

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3
Q

What is an allograft?

A

tissue that is transplanted between members of the same species

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4
Q

What are the 3 topics that need to be assessed in order to determine brain death?

A

ensure the cause of unresponsiveness is not reversible
absence of metabolic central nervous system depression (which must be fixed first)
Absence of toxic cns depression (sedatives, alcohol, neuromuscular blockade)

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5
Q

Can an EEG be used to determine brain death?

A

no

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6
Q

If a person has brain death, will they be positive or negative for the doll’s eye test?

A

negative

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7
Q

What criteria need to be met in order for a person to be a donor?

A

no active bacterial, viral, or severe fungal infections
No active systemic cancers
Assessment of high risk behaviors (IV drug use, etc.)
Absence of hyper/hypotension
Diabetes may or may not be an issue
Corneas less stringent (avascular)

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8
Q

What are the 5 major goals for physiologic management of a donor?

A

maintain hemodynamic stability
maintain optimal oxygenation
maintain normothermia
maintain fluid and electrolyte balance
prevent infectiosn

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9
Q

What is the golden hour for organ donation?

A

the organs must be procured from the donor within an hour after the death of the patient

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10
Q

Which hospitals in arizona perform organ transplants?

A

banner UMC (Tucson)
Mayo clinic (Scottsdale)
St. Joe’s (Phx)
AZ GS Banner UMC

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11
Q

When can an organ be re-transplanted?

A

if the original recipient died from something other than transplant related

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12
Q

How long can a heart be out of a body and on ice before it must be transplanted?

A

4-6 hours

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13
Q

What is different about an ECG for a patient that has had a heart transplant?

A

it will have 2 p waves

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14
Q

What is one of the major complications of receiving a denervated donor heart?

A

The patient may not experience angina, and since they cannot feel pain, the patient may have silent MIs

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15
Q

What are common signs and symptoms of a heart transplant rejection?

A

fatigue/weakness
fever 100.5 or greater
General malaise
SOB
Tachycardia/dysrhythmia
Edema/sudden weight gain
Hypotension

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16
Q

What is a major sign that rejection of a heart transplant is occurring?

A

dysrhythmias

17
Q

What are the clinical indications for a lung transplant?

A

irreversible end stage lung disease, expected to die in 1-2 years

18
Q

Why would a patient need a single lung transplant?

A

COPD, Alpha-1 Antitrypsin Deficiency

19
Q

Why would a patient need a double lung transplant?

A

CF or bronchiectasis

20
Q

why would a patient need a heart/lung transplant?

A

pulmonary HTN or Elsenmenger’s

21
Q

What is the cold time for a lung transplant?

A

4-6 hours

22
Q

What are the common signs/symptoms of rejection?

A

Malaise
Non-productive cough
Dyspnea
Decreased O2 sats
Abnormal pulmonary function test

23
Q

Indications for a liver transplant

A

Primary Biliary Cirrhosis
Other Cirrhosis (non-alcoholic)
Post necrotic, Cryptogenic, TPN induced, Laennec’s
Alcoholic Liver Disease
Chronic Active Hepatitis
Hepatocellular Cancer
Biliary Atresia

24
Q

What is the cold time for a liver transplant?

A

less than 12 hours

25
Q

What is the cold time for a kidney transplant?

A

less than 30 hours

26
Q

What is the test used for kidney rejection diagnosis?

A

ultrasound or biopsy

27
Q

When is a kidney/pancreas transplant indicated?

A

type I diabetes

28
Q

When does hyperacute rejection occur?

A

immediately in the post-op period

29
Q

What needs to be done if a hyperacute rejection occurs?

A

re-transplant or life sustaining treatment

30
Q

When does acute rejection occur?

A

1st 3-6 months after transplant

31
Q

What happens with chronic organ transplant rejection?

A

Chronic inflammation with diffuse scarring and stenosis of the vasculature of the organ
This causes lack of blood supply and ischemia to the organ

32
Q

Side effects of long term corticosteroid use

A

increase in blood sugar, weight gain (increase in appetite), bone disorders (softening), moon face, vision changes, stomach irritation, etc

33
Q

What is the life-long triple therapy that transplant patients do?

A

CSA, Tracrolimus or Rapamune

Prednisone

Imuran or Cellcept

NURS 470 (33 decks)

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