Renal Transplantation Flashcards
1
Q
What occurs prior to renal transplantation?
A
Patient and donor kidneys matched based on HLA A,B,C on chromosome 6 to ensure low chance of rejection
2
Q
How does transplantation take place?
A
- Patients kidneys left in place
- Donor vessels are connected with the pelvic vessels using external iliac vessels
- Ureters connected directly with the bladder
- New kidney placed anteriorly in the abdomen and can usually be palpated in the iliac fossa area
- Hockey stick scar left
3
Q
What occurs post transplant?
A
- Monoclonal antibody given to prevent acute rejection: Basiliximab
- Lifelong immunosuppression with tacrolimus, ciclosporin, azathioprine
4
Q
What are common side effects of the immunosuppressants?
A
- Seborrhoeic warts and skin cancers
- Tacrolimus causes a tremor
- Cyclosporin causes gum hypertrophy
- Steroids cause Cushings syndrome features
5
Q
What are some complications of renal transplantation?
A
- Rejection/Failure
- Electrolyte imbalances
- Immunosuppressants can cause CVD, T2DM, Infections, Lymphoma and skin cancer
6
Q
What unusual infections can occur in those being immunosuppressed?
A
- Pneumocystis jiroveci pneumonia
- CMV
- TB
