Transplants Flashcards
hyperacute organ rejection by which HLA
IgG anti HLA Class I antibodies
Complications of Transurethral Resection: TURP
Complications of Transurethral Resection: TURP
T ur syndrome
U rethral stricture/UTI
R etrograde ejaculation
P erforation of the prostate
Complications of Transurethral Resection: TURP
Complications of Transurethral Resection: TURP
T ur syndrome
U rethral stricture/UTI
R etrograde ejaculation
P erforation of the prostate
l” ndependent digestion from pancreas function
Folic Acid
pulmonary embolus causes. which. pH abrmorality
Respiratory alkalosis
Rx of
Hyperacute rejection
Acute rejection
Hyper : remove donor organ
Acute: corticosteroids
Corticosteroid causes apoptosis or necrosis
Apoptosis
whichorgan is most prone to hyperacute rejection
Kidney
Hyperacute VS Acute Rejection way
Hyper by ABO incompatibility and HLA Class I incompatible
Acute by T cells
Organ specific changesafter transplant
loss of acinar cells in pancreas transplants and
rapidly progressive coronary artery disease in cardiac transplants.
myointimal proliferation leading to organ ischaemia in which type of rejection
Chronic
Survival rate of cadavers vs monozygotic twins
Cadavers: 9 years
Mono: 25
Corticosteroid function after transplants
- Supression of macrophage activation
- Reduction in lymphocyte proliferation
- Apoptosis of lymphocyte
- Reduction in expression of endothelial cell adhesion molecules
Complication of renal transplant after few months
Renal Artery Stenosis
induction agent in kidney transplantation,
Basiliximab
CMV causes which type of rejection
Acute
Recurrence of original renal disease
MCGN > IgA > FSGS
importance of the HLA antigens are as follows
DR > B > A
Most common post transplant infection
Cmv
treatment of choice in transplant induced CMV infection
Intravenous ganciclovir
Which HLA is most imp
DR
Which drug shouldn’t be given post renal transplant
NSAID like Diclofenac
Post transplant complications
CMV vs EBV
CMV: 4 weeks to 6 months post transplant
EBV: post transplant lymphoproliferative disease. > 6 months post transplant
Vascular complication post transplant
Renal artery/vein thrombosis occurs very early
Renal artery stenosis: after several months
immunosuppressive therapies have limited effectiveness in reversing which kind of rejection
chronic rejection
Which organ is most susceptible to donor- recipient HLA mismatches?
Kidney
If taking Tacrolimus what to avoid
Grapefruit juice,watercress and St.Johns Wort
1st line agent as immunosuppressive agent
Tacrolimus
Right sided live donor transplants
then sudden loss of urine
Renal Artery stenosis
hyperacute graft rejection by which
IgG
commonest causes of anuria post transplant
Blocked catheter or hypovolemia
in the first 5 weeks following transplantation with pain and swelling at the graft site.
Most likely ureteric obstruction or leakage
Rx of lymphocole
Creation of a laparoscopic or open peritoneal window is a favored treatment.
Rx of ureteric leaks
Surgical re-implantation of the ureter for large leaks and
Stent insertion and nephrostomy placement for smaller leaks.
Occurs within minutes of clamp release
Hyperacute rejection
Pre-sensitisation of the donorcauses which kind of injury
Accelerated acute
Histology of acute vs Chronic rejection
Acute: cellular infiltrates and graft cell apoptosis
Chronic: graft atrophy and atherosclerosis are seen. Fibrosis often occurs as a late event
Anti-proliferative agents example
Mycophenolate mofetil or azathioprine.
Side effects of Azathioprine
myelosupression, alopecia and nausea
Side effects of tacrolimus
high incidence of impaired glucose tolerance and diabetes
less hypertension and hyperlipidaemia
