Renal Transplantation

Question 1

How to assess potential recepients?

Answer 1

1. Will they live for more than 5 years?

2. Make sure patient is safe to undergo the operation
General Anaesthetic
Surgical Procedure
Immunosupression
Immediate post-operative period
Extensive assessment process
No survival benefit until after 3 months

Question 2

Contraindications to transplantation

Answer 2

1. Malignancy
   - Known untreated malignancy
   - Solid tumour in last 2-5 years

2.active HCV/HIV infection

3. Untreated TB
4. Severe IHD, not amenable to surgery
5. Severe airways disease
6. Active vasculitis
   Severe PVD (unusable vessels)
   Hostile bladder

Question 3

Live donor assessment

Answer 3

Physical fitness for surgery?
Enough renal function to remain independent after nephrectomy?
Anatomically normal kidneys?
Any co-morbidities?
Hypertension, Proteinuria, Haematuria?
Immunologically compatible?
Psychologically compatible?
Coming forward without coercion?

Question 4

Human Leukocyte Antigen

Answer 4

present on the surface of antigens –> identified by DNA sequence

Question 5

Which are the sensitising events that can lead to the formation of pre-formed antibodies to non-self antigens?

Answer 5

Blood transfusion
Pregnancy or miscarriage
Previous transplant