Organ Transplant Flashcards

1
Q

organ transplant

A

can provide long-term survival outcomes in otherwise fatal disease

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2
Q

which organs can only be harvested from a deceased donor?

A

heart and intestines

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3
Q

which organs can be harvested from an alive donor?

A
  • kidney
  • liver
  • pancreas
  • bone marrow
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4
Q

principles of organ transplantation

A
  • immunology underlying proper donor and recipient matching

- immunosuppression for prevention and management of graft rejection

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5
Q

why are recipients for transplants significantly immunocompromised?

A
  • decrease ability of host to mount response and destroy new organ
  • pancytopenia
  • increased risk for infection (WBCs)
  • increased risk for bleeding (platelets)
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6
Q

immunosuppressive agents used

A
  • corticosteroids
  • antimetabolites
  • calcineurin inhibitors
  • mTOR inhibitors
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7
Q

complications of organ transplantation

A
  • graft rejection
  • problems related to chronic immunosuppressive therapy
  • problems specific to the transplanted organ
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8
Q

what are some problems related to chronic immunosuppressive therapy in organ transplantation?

A

block T and B-cell activity as well as innate immunity

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9
Q

pre-transplant management

A
  • significant immunosuppression to get body ready for transplant
  • require comprehensive dental screening and clearance to reduce infection risk
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10
Q

bone marrow transplant pts have to undergo what before transplantation?

A

total body radiation in addition to chemotherapy

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11
Q

pre-transplant dental considerations

A
  • dental exam to diagnose and treat active or potential disease
  • work with managing transplant team to optimize pt for the needed dental procedures
  • continue preventive care throughout transplant phases
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12
Q

what type of dental txtments can organ transplant pts have the first 6 months post-transplant?

A

emergency only

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13
Q

how should active or potential disease be treated in pts pre-transplant?

A

expeditiously and aggressively

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14
Q

most common type of transplant?

A

kidney

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15
Q

dental concerns for pts w/ HF?

A

stress

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16
Q

dental concerns for pts w/ ESRD?

A

dialysis concerns and altered drug metabolism

17
Q

dental concerns for pts w/ liver failure?

A

drug metabolism and coagulation

18
Q

dental concerns for pts w/ severe diabetes?

A

insulin rxns and infection risk

19
Q

organ transplant pts need prophylactic antibiotics to prevent infection?

A
  • there’s no standard of care for these pts so consults with transplant managing team
  • Dr. Kennedy would prescribe prophylactic antibiotics though
20
Q

can you provide routine dentistry to organ transplant pts during the stable period (>6 months post-transplant)?

A

yes but pt’s immune system is suppressed for life so let managing team advise txtment

21
Q

which type of pts need dental clearance first before starting txtment?

A
  • pts with heart valve replacement
  • pts on anti-resorptive drugs
  • pts that are going to undergo radiation therapy to head and neck
  • pts that are undergoing chemotherapy
22
Q

how long should a pt wait from an extraction to receive radiation therapy?

A

at least 2 wks

*for epithelium to heal over socket