RENAL - DIALYSIS AND RENAL TRANSPLANTATION Flashcards

Question

What are the disadvantages of haemodialysis?

Answer 1

If sessions are in a dialysis clinic you need to travel there regularly Diet and fluid intake must be restricted Can cause fatigue, low bp, sepsis, muscle cramps, itchy skin Both you and your dialysis partner must attend training Less privacy as other people are doing dialysis at the same time Family and friends can’t be with you during treatment in centre

Answer 2

Can be done at home Fewer restrictions on diet and fluid intake compared with haemodialysis PD is more portable and doesn’t use needles

Answer 3

It may not be appropriate for those who are morbidly obese or had prior abdominal surgeries. increased risk of peritonitis Visually - catheter left in your belly permanently Needs to be carried out every day which can be disruptive In rare cases the peritoneum may gradually become thickened and scarred and people may need to switch to haemodialysis after a few years to stop this happening Dialysis fluid used can cause a reduction in protein levels which can lead to a lack of energy and malnutrition Increased risk of developing hernias due to a strain on the muscles It may cause weight gain as the dialysate fluid contains sugar molecules

Answer 4

The cost of patient therapy by haemodialysis at end-stage renal disease is far greater than performing transplantation and maintenance by almost 3.5 times. Quality of life is also said to be 20% greater in transplant patients

Answer 5

No shortage so is available to all kidney patients No need for immunosuppressant drugs

Answer 6

Patients can lead a more normal life without having to limit their diet and fluid intake Cheaper for the NHS overall Less impact on life as no regular dialysis sessions

Answer 7

Living donor - 20-25 years Deceased donor - 15-20 years

Answer 8

a regulator set up in 2005 following events in the 1990s that revealed a culture in hospitals of removing and retaining human organs and tissue without consent. They now regulate organisations that remove, store and use human tissue for research, medical treatment, post-morgen examination, education and training, and display in public. They also give approval for organ and bone marrow donations from living people.

Answer 9

1- Removing, storing or using human tissue for Scheduled Purposes without appropriate consent. 2 - Storing or using human tissue donated for a Scheduled Purpose for another purpose. 3 - Trafficking in human tissue for transplantation purposes. 4 - Carrying out licensable activities without holding a licence from the HTA 5 - Having human tissue with the intention of its DNA being analysed without the consent of the person from whom the tissue came or of those close to them if they have died.

Answer 10

The donor bears almost all risk and the recipient is the primary beneficiary Donor may gain psychosocial benefits Donor may have life long health problems, may have difficulties getting insurance etc Issues with informed consent e.g. pressure, coercion Selling organs or having financial incentives

Answer 11

Those under the age of 18 Those without capacity to understand the new arrangements and take necessary action Visitors to England Those living in England involuntarily Those who only lived in England for less than a year before their death

Answer 12

Blood typing Tissue typing Cross matching

Answer 13

Measuring blood antibodies that react with different blood groups

Answer 14

Donors with blood type A can donate to recipients with blood types A and AB. Donors with blood type B can donate to recipients with blood types B and AB. Donors with blood type AB can donate to recipients with blood types AB only. Donors with blood type O can donate to recipients with all blood types

Answer 15

The better the HLA match, the more successful the transplant will be Complete compatibility at A, B and DR loci offers the best long-term. Outcomes

Answer 16

A blood test that you and the donor will have multiple times, including right before your transplant surgery Cells from the donor are mixed with your serum. If your serum has antibodies against the donor’s cells, the antibodies will bind the donor cells and be detected using a fluorescent detection method. If these antibodies are at high levels, the donor cells will be destroyed = positive cross match and transplant cannot take place as would result in an immediate rejection of the kidney.

Answer 17

Everyone in England over the age of 18 will be considered to be in favour of donating their organs and tissues after death unless: - they have said they don’t want to donate their organs - they have appointed a representative to decide for them after their death - they are in one of the excluded groups – under the age of 18, ordinarily resident in England for less than 12 months before their death, or lack mental capacity for a significant period before their death

Answer 18

No. The family of the deceased will always be consulted first and will be able to provide information on their loved ones wishes If they have information that their loved one would not have wanted to donate their organs then organ donation will not go ahead

Answer 19

The government has decided to change the law because there is a shortage of available organs in England. Three people die waiting for an organ each day. Although 80% of people say they would be happy to donate their organs after their death, only 37% are registered as donors. To increase the number of donors, the government changed the law in line with what the majority of people want to do.

Answer 20

Doctors can remove organs from every adult who dies unless they have registered to opt out

Answer 21

Doctors can remove organs from every adult who dies unless they registered to opt out or the persons relatives tell doctors not to take organs