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Nephrology > Transplant > Flashcards

Transplant Flashcards

1
Q

What are the risks for re-transplant allograft failure?

A

Prior allograft failure
Nephrectomy of allograft
Past pregnancy

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2
Q

How can a calcineurin inhibitor result in hyperkalemia?

A

CNIs activate the Na/Cl co-transporter in the DCT resulting in less distal sodium delivery to ENaC

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3
Q

What drugs can result in increased levels of tacrolimus?

A

Azoles
Diltiazem
Ritonavir
Grapefruit juice

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4
Q

What drugs can result in decreased levels of tacrolimus?

A

Rifampin
Carbamazepine
St. John’s Wort

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5
Q

Immunosuppressant associated with skin tags?

A

Azathioprine

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6
Q

Immunosuppressant associated with decreased risk of squamous cell recurrence?

A

mTORi

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7
Q

Alternative to MMF with less GI side effects?

A

Mycophenolic acid

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8
Q

Immunosuppressant associated with alopecia and tremors?

A

Tacrolimus

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9
Q

Immunosuppressant associated with hirsuitism and gingival hyperplasia?

A

Cyclosporine

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10
Q

Immunosuppressant associated with delayed wound healing?

A

Everolimus/sirolimus

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11
Q

What are the standard prophylaxis agents used in post-transplant period?

A

Fluconazole (1 month)
TMPSMX (6 months)
Valganciclovir (3 months/6 months)

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12
Q

What is the treatment for acute cellular rejection?

A

Borderline: PO pulse steroids
ACR 1A: IV pulse steroids
ACR 1B+: IV pulse steroids + antithymocyte globulin

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13
Q

What is the treatment for acute antibody mediated rejection?

A

PLEX x 3
IVIG + steroids
Rituximab (if lots of DSA)

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14
Q

How do you diagnose acute antibody mediated rejection?

A

(@ least 2):
1) Peritubular capillaritis
2) C4d staining in peritubular capillaries
3) DSA +

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15
Q

How do you desensitize prior to transplant in those with high Panel Reactive Antibody %?

A

PLEX

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16
Q

Which immunosuppresant class can cause in proteinuria?

A

mTORi

17
Q

What are absolute contraindications for renal transplantation?

A

Active malignancy
Prostate cancer within 2 years
Breast/Melanoma/Myeloma within 5 years
BMI > 40

18
Q

Belatacept should be avoided in patients with exposure to what infection?

A

EBV

19
Q

CrCl cutoff for kidney transplant donor?

A

80

20
Q

Transplanted patients with ESKD from Alport’s disease are at risk for allograft dysfunction from what condition?

A

Anti-GBM Ab disease

21
Q

Recurrent FSGS usually occurs within what time frame?

A

First 12 months post-transplantation

22
Q

What is the pathophysiology and treatment for cytokine release syndrome secondary to ATG exposure?

A

Elevated IL6
Tocilizumab

23
Q

Cyclosporine can _____________ mycophenolic acid levels?

A

lower

Nephrology (10 decks)

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