Transplant Part 1

Question 1

5 contraindications to receiving a transplant

Answer 1

Active infections
Active malignancy
Active psychiatric illness
Unacceptably high perioperative risk (unrevascularizable CAD)
High burden of comorbid conditions (dementia, end stage lung/heart disease)

Question 2

Why is a living donor transplant the best option?

Answer 2

Shortest time to transplant (compared to deceased donor wait time)
Lowest perioperative risk
Better graft longevity

Question 3

Expanded criteria for a deceased donor

Answer 3

Donors are older, may have more comorbidities (DM, HTM)

The kidneys wont last as long but they will work - better than no kidneys

Question 4

Donation after cardiac death

Answer 4

Not fully technically brain dead, have to take off life support and wait
Perfusion can be really low for a long time - can ruin the organs
50% will still need some dialysis in the first week

Question 5

2 immune mechanisms of graft rejection

Answer 5

T cell mediated (cellular rejection - acute rejection - can treat this well)
B cell mediated (Ab mediated rejection - long term - cannot treat this well)

Question 6

Hyperacute rejection is caused by….

Answer 6

Antibodies

Ab to the HLA molecules on the donor kidney

Question 7

4 circumstances where you can get exposed to foreign HLA and make Abs

Answer 7

Pregnancy
Blood transfusion
Transplantation
Infection