Renal Transplantation Flashcards
What is the characteristic of End Stage Renal Disease?
GFR rate of <10 ml/min
OR
Serum creatinine of 800
What are the common diseases of End Stage Renal Disease:
Glomerulonephritis
Hypertension
Autosomal dominant poly cystic disease
Donates Mellitus
What are the treatment options for ESRD?
Renal transplant
Haemodialysis
Peritoneal Dislysis
What are the benefits of RenalTransplants?
- More cost effective
2. Better quality of life than dialysis
What is hyper acute rejection?
Rejection of the Kidney that occurs upon revascularisation
Mainly as a result of the cytotoxic antibodies
What is the definition of acute rejection?
This occurs weeks and months later
Cell mediated
What is the Rx of acute rejection of the kidney?
High dose pulses of steroids
What is chronic rejection?
Occurs years after transplantation
Probably antibody mediated
What are 5 criteria for a healthy renal donor?
No malignancy
No active infection
No Diabetes Mellitus
No renal disease
Paraneoplastic syndrome
When the tumour makes its own hormones such as Erythropoeitin which increases the RBC-polycythemia
What pump is associated with warm ischaemia of the kidney?
Sodium potassium pump
What is warm ischaemia of the kidney?
Cell death via failure of the sodium potassium pump which leads to sodium and water diffusion into the cells
What is the name of the hyperosmolar solution used to reperfuse the kidney?
Euro-Collins
What are the immunosuppressive drugs given for renal transplantation
- Cyclosporin
- Prednisone
- Azathioprine
What are the complications of renal transplantation?
UTI
Ureteric obstruction
Fluid collections or leaks
Acute rejection
What are the features of acute rejection in renal transplantation?
- Flu like illness
- hypertension
- increases serum creatinine
- decreased urine output
In which side is the renal transplantation done in the recipient?
The Right Iliac Fossa
The donor renal artery is anastomosed to the___
Either the external/internal iliac artery
The donors renal vein is anastomosed to the____
Recipients External iliac vein
What are the 7 things that the multidisciplinary team factors in with renal transplantation?
- Compliance of the pt.
- Urological disease -renal calculi etc.
- Vascular disease -peripheral vascular disease
- Co morbidities-obesity
- Kidney disease recurrence
- Malignancy - must be free for 2 years
- Infections
Early complications of renal transplantation
- bleeding
- urinary leak- urinoma
- infection at surgical site
- UTI
- lymph can leak out
Late complications of renal transplantation
- recurrent UTI
- uteral anastomotic stricture
- voiding dysfunction
- incisional hernia
