Renal - Renal Transplant Flashcards
How many years does a renal transplant add vs dialysis only?
10 years
Improves QoL
Label the image
What is donor matching based on?
Human leukocyte antigen
HLA type A,B and C on chromosome 6
Does not have to fully match, closer the better
How is a renal transplant carried out?
Patient’s kidneys left in place
Donor kidney blood vessels anastomosed to external iliac vessels
Ureter anastomosed directly with the bladder
Placed anteriorly in iliac fossa
Hockey-stick incision and scar
How long does it take for the transplant to work?
New kidney functions immediately
What is Basiliximab used for?
Basiliximab targets the interleukin-2 receptors on T-cells
Two doses given after surgery to prevent acute rejection
What drugs are given for life-long immunosuppression?
Tacrolimus
Mycophenolate
Cyclosporine
Azathioprine
Prednisolone
What signs should you look for when examining a patient with a renal transplant?
Seborrheic warts and skin cancers (scars from skin cancer removal)
Due to immunosuppressants
Tremor
Tacrolimus
Gum hypertrophy
Cyclosporine
Cushing’s syndrome
Steroid use
What complications are there relating to the transplant?
Transplant rejection (hyperacute, acute or chronic)
Transplant failure
Electrolyte imbalances
What complications are there related to immunosuppressant use?
Ischaemic heart disease
Type 2 diabetes (steroids)
Infections more likely
Non-Hodgkin lymphoma
Skin cancer (squamous cell carcinoma)
What are some rarer infections caused by immunosuppressants?
Pneumocystis jiroveci pneumonia (PCP)
Cytomegalovirus (CMV)
Tuberculosis (TB)
