Pediatric Lung Transplant Flashcards
MC indication for lung transplant among children aged 1-5 yo
Pulmonary HP
Absolute contraindications in pedia lung transplant
HIV
Hepa B and C
TB
Malignancy
B cenocepacia colonizatiij
liver, renal or left vent failure
psych
relative contraindication in Lung transplant
this relative contraindication is associated with high mortality and may prolong ischemic time
prior pleurodesis
bridge to transplant
ECMO
PFT of px post transplant with acute rejection
obstructive
onset of acute rejection
earliest 1 week after
to 2 to 3 yrs later
MC 2 weeks-12 weeks
histologic pattern in acute rejection
perivascular lymphocytic infiltrates +- airway inflammation
most frequent problem in 1st post transplant week
primary graft dysfunction
complication of Primary graft dysfunction
non cardiogenic edema
histology of primary graft dysfunction
DAD
hyperacute rejection mechanistm
binding of recipient antibodies to donor human HLA molecules leading to ischemia
tx for acute rejection
methylpred 10mg/kg for 3 days
In early phase (1-6 months), allo antibody response or anti HLA antibodies comes from
the donor
Antibody-mediated rejection (AMR) in Early phase , can develop in response to self antigens (AUTO antibody response) such as
collagen V
k alpha 1 tubulin
Clinical manifestation of acute rejection
dyspnea, infiltrates, dec lung function
tx of early phase acute rejection
steroids
plasmapharesis
ivig
b cell reduction
risk of infection is highest at this phase
early phase
leading cause of death after the 1st yr post transplant
Bronchiolitis obliterans
medication side effects of CSS
hpn
nephropathy
csa based immunosup
hirsutisim, gingival hyperplasia
tacrolimus
DM
most common malignancy after lung transplant
post transplant lymphoproliferative disease (EBV driven lymphoma)
most common site of PTLD
allograft
