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1. Renal > Renal transplant > Flashcards

Renal transplant Flashcards

1
Q

What extra renal function percentage does dialysis give?

A

7%

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2
Q

What extra renal function percentage does transplant give?

A

50%

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3
Q

How is transplant rejection avoided?

A

immunosuppresion

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4
Q

How long must you be cancer free to be a organ donor?

A

2-5 years

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5
Q

What is a key part in paring of donors and recipients?

A

need to make sure the recipient does not have antiboies to the donors HLA

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6
Q

What things lead to preformed antibodies?

A

blood transfusion
pregnancy
miscarriage
previous transplant

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7
Q

What is densensitisation?

A

active removal of blood group or donor specific antibody

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8
Q

How can densensitisation be brought about?

A

plasma exchange

B cell antibody (rituximab) - knocks out B cells and stops them making antibodies

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9
Q

Where are renal transplants placed?

A

iliac fossa

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10
Q

What is delayed graft function?

A

often need HD in the interim, usually works in 10-30 days

can cause post transplant ATN

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11
Q

What is hyperacute rejection due to?

A

preformed antibodies

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12
Q

What is acute rejection due to?

A

cellular or antibody mediated - treat by increasing immunosuppresion

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13
Q

What is chronic rejection?

A

slow progressive decline in renal function

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14
Q

What does antirejection therapy comprise of?

A

reduced T cell activation through immunosuppression - before, during and after the transplant

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15
Q

What infections are those with renal transplants susceptible to?

A

CMV, HSV, BK
PJP pneumonia
fungal infections

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16
Q

What is CMV?

A

renal and hepatic dysfunction, oesophagitis, colitis
associated with early graft loss
treated with valganciclovir

17
Q

What is BK nephropathy?

A

shows over immunosuppression - indolent in the uroepithelium
treat by lowering immunosuppression and monitor blood viral load by PCR

18
Q

What are the most common malignancies associated with renal transplants?

A

non melanoma skin cancers
lymphoma or EBV mediated PTLD
solid organs

19
Q

What is EBV mediated PTLD?

A

post transplant lymphoproliferative disease
- EBV infection causes B cell proliferation then monoclonal proliferation then lymphoma
treatment - reduce immunosuppression and chemo

1. Renal (28 decks)

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