Renal transplant Flashcards
What are the 3 types of failure and when do they occur?
Hyperacute (minutes to hours post transplant)
Acute (<6 months post transplant)
Chronic (>6 months post transplant)
What are the symptoms of acute graft failure?
Pyrexia
Enlargement and tenderness over the transplanted organ
Biochemical dysfunction i.e rise in creatinine in renal transplant
What are the complications of renal transplant?
Graft Rejection Delayed graft function Infection Thrombosis Surgical problems: lymphocele, hernia Malignancy (result of immunosuppression)
What advice would you give to patients post-transplant and is on immunosuppressants?
Avoid excessive exposure to sun due to increased risk of SCC
What are some side effects of immunosuppression in renal transplant?
Hypertension Hyperlipidaemia Impaired glucose tolerance i.e ciclosporin Increased risk of infection Increased malignancy risk
What are some side effects of immunosuppression i.e calcineurin inhibitors in renal transplant?
Hypertension Hyperlipidaemia Impaired glucose tolerance Increased risk of infection Increased hair growth (ciclosporin) Hyperkalaemia (ciclosporin)
What are some side effects of immunosuppression i.e antimetabolites in renal transplant?
Anaemia
Leukopenia
GI toxicity
What are some examples of antimetabolite immunosuppresants?
Mycophenolate Mofitil
Azathioprine
What are examples of calcineurin inhibitors? What is their function?
Ciclosporin
Tacrolimus
They inhibit T cell activation and proliferation
Which virus can often be found in SCC lesions?
HPV
Should you stop immunosuppression in patients with renal transplant if they get an infection?
No (different from rheumatological problems), for risk of organ rejection
What are the 3 levels of matching in organ transplant?
ABO matching
HLA matching
Lymphocytotoxic crossmatching (if reactive = hyperacute organ rejection
