Organ Transplantation Flashcards

1
Q

Who is eligible as an organ donor?

A

-Virtually all brain-dead patients, regardless of age

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2
Q

What can be done with donors who have specific infections?

A

-Their organs can be given to a recipient with a similar infection (for example: hepatitis)

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3
Q

What is the general rule for physicians regarding donor eligibility?

A

-Potential donors are referred to harvesting teams and they will exclude the few that cannot be used at all

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4
Q

Which is the one absolute contraindication to organ donation?

A

-HIV positive status

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5
Q

What are the ways in which transplant rejection can happen?

A
  • Hyperacute
  • Acute
  • Chronic
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6
Q

What is hyperacute rejection?

A
  • Vascular thrombosis within minutes of reestablishing blood supply to the organ
  • Caused by preformed antibodies
  • Prevented by ABO matching and lymphocytotoxic crossmatch (Not sen clinically)
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7
Q

What is acute rejection?

A
  • Occurs after first five days and usually within the first 3 months
  • Episodes occur even if patient is on immunosuppressives
  • Suggested by signs of organ dysfunction
  • Confirmed by biopsy
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8
Q

What is the most common cause of liver transplant rejection?

A

-Technical problems (not immunologic)

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9
Q

What are the signs of liver transplant failure?

A

-Rising gamma-glutamyltransferase (GGT), alkaline phosphatase, and bilirubin

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10
Q

What should be done first when liver function deteriorates after a transplant?

A

-R/o biliary obstruction by US and vascular thrombosis by doppler

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11
Q

What is important to keep in mind regarding heart transplant rejection?

A

-Signs of functional deterioration occur too late to allow for effective therapy
-Routine ventricular biopsies (via jugular, SVC and right atrium) are done at intervals
-

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12
Q

What is the first line therapy for rejection?

A

-Steroid boluses

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13
Q

What other treatments are available for acute rejection if first line treatment fails?

A
  • Antilymphocyte agents (OKT3), but have higher toxicity

- Antithymocyte serum is tolerated better

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14
Q

What is chronic rejection?

A
  • Seen years after a transplant w gradual, insidious loss of organ function
  • Poorly understood and irreversible
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15
Q

How is chronic rejection managed?

A
  • There is no treatment

- Patients undergo biopsies in the hope that it may be a delayed and treatable case of acute rejection.

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