Organ Transplant Flashcards
List the most common organs to be transplanted
- Kidney
- Liver
- Heart
*other → pancreas, lung and intestine
what are VCAs?
Vascular composite allografts
involve the transplantation of multiple structures that may include skin, bone, muscles, blood vessels, nerves and connective tissue
face and hand more common type of VCAs
What are the basic criteria for transplantation
- presence of end-stage disease in a transplantable organ
- failure of conventional therapy to treat the condition successfully
- absence of untreatable maligancy or irreversible infection
- absence of disease that would attack the transplanted organ or tissue
In order to get an organ transplant, candidates must:
- demonstrate emotional and psychological stability
- have an adequate support system
- be willing to comply w/lifelong immunosuppressive drug therapy
where do the organs for transplants come from?
- Cadaveric donors
- ppl involved in trauma, determined to be neurologically dead
- cardiopulmonary support/mechanical vent required to maintain viability of organ
- Living donors
- stem cells, kidney transplant, liver, lung and pancreas transplantation
- can be relative, friend or stranger
- “best fit” = someone of similar height/weight
what is the UNOS?
United Network for Organ Sharing
sets standards for transplant centers and teams, tissue typing labs, and organ procurement organizations
list some factors in decisions to allocate organs
- ABO blood typing
- tissue (histocompatibility) typing
- size
- waiting time
- severity of illness/degree of med urgency
- geo location (distance between donor and recipient)
how long are organs viable?
- Heart → 4-6 hrs
- Lungs → 4-6 hrs
- Pancreas → 24 hrs
- Liver → 24-30 hrs
- Kidneys → 48-72 hrs
list some pre-op pt issues
- weakness
- possibly prolonged hospitlization
- fatigue
- extended confinement to bed or home
- poor functional mobility including gait
- poor breathing mechanics
- poor airway clearance
describe post-op care for an organ donor
- taken off mechanical vent in recovery room and transferred to general surgery or transplant ward
- VS and blood counts monitored
- keep eye out for post op bleeding
- pts usually out of bed and walking by POD1
- PT is only invovled in instances of complications
Describe post-op care for an transplant recipient
- post-op care focuses on:
- allograft function
- rejection
- infection
- AE of immunosuppressive drugs
- Complications related to:
- surgical/medical
- rejection
- infection
what is the leading problem of organ transplants?
transplant rejections
list 3 drug approaches to post-transplant management
- induction immunosuppression
- maintainence immunosuppression
- antirejection immunosuppression
what are some PT considerations for pts on immunosupressive agents following transplantation?
- increased risk for infection
- all drugs have serious AE:
- systemic symptoms → N/V, fever, chills
- liver and kidney toxicity
- mental status changes
List the types of graft rejections
- Hyperacute rejection
- Acute rejection
- Chronic rejection