Renal transplant longs Flashcards
Where does the exocrine part of the transplant pancreas drain?
Bowel in old surgery and bladder in new
What is the initial failure rate for pancreas transplant
7-10%
RF: large donor/recipient, long ischaemia time, low blood pressure
Post transplant complications
Malignancy Cardiac - inc RF (diabetes, lipids) Infection Bones Haematology
Ddx of current (renal) graft dysfunction
Normal renal issues (pre/renal/post Rejection issues Disease recurrence DIabetes Calcineurin inhibitor toxicity
Tacrolimus SE
Hair loss DIabetes Nephrotoxic HTN Neurotoxic Thrombotic microangiopathy HyperK, HypoMg, Hyperuricaemia CYT P450
Cyclosplorin vs tac SE
Similar but cyclosplorin has hirsutism, less diabetogenic
Mycophenolate SE
GI tract
Colitis
Anaemia
Leucopenia
mTOR inhibitor SE
painful mouth ulcers Hyperlipidaemia Cytopenias Wound problems Proteinuria
How long is valganciclovir continued for in renal transplant
3-6 months normally if either donor/recipient is positive
What transplant drugs have issues with reproduction
Teratogenic: mycophenolate
Reproduction: sirolimus
What are features of antibody mediated rejection (renal)
positive C4d staining, tubular sparing
Antibody mediated rejection treatment
Plasma exchange
IVIG
Splenectomy
Bortezomib, eculizumab
What to examine for renal transplant
Fluid status BP Abdomen - graft, polycystic kidney Associated conditions IS related
half life of kidney transplants
13-15 years
