Renal Transplantation

Question 1

What is the characteristic of End Stage Renal Disease?

Answer 1

GFR rate of <10 ml/min
OR
Serum creatinine of 800

Question 2

What are the common diseases of End Stage Renal Disease:

Answer 2

Glomerulonephritis
Hypertension
Autosomal dominant poly cystic disease
Donates Mellitus

Question 3

What are the treatment options for ESRD?

Answer 3

Renal transplant
Haemodialysis
Peritoneal Dislysis

Question 4

What are the benefits of RenalTransplants?

Answer 4

1. More cost effective

2. Better quality of life than dialysis

Question 5

What is hyper acute rejection?

Answer 5

Rejection of the Kidney that occurs upon revascularisation

Mainly as a result of the cytotoxic antibodies

Question 6

What is the definition of acute rejection?

Answer 6

This occurs weeks and months later

Cell mediated

Question 7

What is the Rx of acute rejection of the kidney?

Answer 7

High dose pulses of steroids

Question 8

What is chronic rejection?

Answer 8

Occurs years after transplantation

Probably antibody mediated

Question 9

What are 5 criteria for a healthy renal donor?

Answer 9

No malignancy
No active infection
No Diabetes Mellitus
No renal disease

Question 10

Paraneoplastic syndrome

Answer 10

When the tumour makes its own hormones such as Erythropoeitin which increases the RBC-polycythemia

Question 11

What pump is associated with warm ischaemia of the kidney?

Answer 11

Sodium potassium pump

Question 12

What is warm ischaemia of the kidney?

Answer 12

Cell death via failure of the sodium potassium pump which leads to sodium and water diffusion into the cells

Question 13

What is the name of the hyperosmolar solution used to reperfuse the kidney?

Answer 13

Euro-Collins

Question 14

What are the immunosuppressive drugs given for renal transplantation

Answer 14

• Cyclosporin
• Prednisone
• Azathioprine

Question 15

What are the complications of renal transplantation?

Answer 15

UTI
Ureteric obstruction
Fluid collections or leaks
Acute rejection

Question 16

What are the features of acute rejection in renal transplantation?

Answer 16

• Flu like illness
• hypertension
• increases serum creatinine
• decreased urine output

Question 17

In which side is the renal transplantation done in the recipient?

Answer 17

The Right Iliac Fossa

Question 18

The donor renal artery is anastomosed to the___

Answer 18

Either the external/internal iliac artery

Question 19

The donors renal vein is anastomosed to the____

Answer 19

Recipients External iliac vein

Question 20

What are the 7 things that the multidisciplinary team factors in with renal transplantation?

Answer 20

1. Compliance of the pt.
2. Urological disease -renal calculi etc.
3. Vascular disease -peripheral vascular disease
4. Co morbidities-obesity
5. Kidney disease recurrence
6. Malignancy - must be free for 2 years
7. Infections

Question 21

Early complications of renal transplantation

Answer 21

• bleeding
• urinary leak- urinoma
• infection at surgical site
• UTI
• lymph can leak out

Question 22

Late complications of renal transplantation

Answer 22

• recurrent UTI
• uteral anastomotic stricture
• voiding dysfunction
• incisional hernia