Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Levi's Class 2014 > Week 4 Organ Transplantation, Donation, and Procurement > Flashcards

Week 4 Organ Transplantation, Donation, and Procurement Flashcards

1
Q

What organs can be transplanted:

A
  • Kidney
  • Liver
  • Lung
  • Heart
  • Heart and Lung
  • Pancreas
  • Small intestine
  • Cornea
  • Skin
  • Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T/F: An individual’s signature on a driver’s license or donor card indicating their desire to donate their organ is NOT legally binding and does require family permission.

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the three classification of an organ donor?

A
  • Brain Death Donors
  • Donation After Cardiac Death (DCD)
  • Living Donors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the US Uniform Determination of Death ACT (1980) define DEATH:

A

-Irreversible cessation of circulatory and respiratory functions, or of all functions of the entire brain, including the brain stem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the criteria for diagnosis of BRAIN DEATH:

A

-Loss of cerebral cortical function
>No spontaneous movement
>Unresponsive to external stimuli

-Loss of Brainstem Function
>Apnea
>Absent cranial nerve reflexes (papillary,
corneal, oculocephalic, oculovestibular)

-Supporting Documentation
>EKG
>Cerebral blood flow studies (angiography,
transcranial Doppler, xenon scan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the four common physiologic derangements after brain death?

A
  • Hypotension
  • Arterial hypoxemia
  • Hypothermia
  • Cardiac dysrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes hypotension after brain death?

A
  • Hypovolemia (diabetes insipidus, hemorrhage)

- Neurogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes Arterial hypoxemia after brain death?

A
  • Neurogenic pulmonary edema
  • Aspiration
  • Pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes hypothermia after brain death?

A

-Hypothalamic infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What causes cardiac dysrhythmias after brain death?

A
  • Hypothermia
  • Arterial hypoxemia
  • Electrolyte abnormality
  • Myocardial ischemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anesthesia management is _____ for organ donation after brain death. (DBD)

A

required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anesthesia management is _____ for organ donation after cardiac death. (DCD)

A

not required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F: Approximately 44% of organ donation come from living organ donors?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the ages of living donors?

A

18 - 60 year of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Are living organ donors usually related?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A living organ donor must not have any of this on their physical history?

A
  • Hypertension
  • Diabetes
  • Cancer
  • Kidney disease
  • Heart desease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some ABSOLUTE contraindication to organ IMPLANTATION?

A
  • Active uncontrolled infection
  • AIDS
  • Inability to tolerate immune suppression
  • Severe cardiopulmonary/medical condition
  • Continued drug or alcohol abuse
  • Extrahepatic Malignancy
  • Inability to comply with medical regimen
  • Lack of psychosocial support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some contraindication to solid organ transplantation?

A

-Active infectious process until treated and infection resolved

-Severe irreversible pulmonary hypertension
>not a canidate for heart transplant
>may be a candidate for heart lung transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Frequency of skin and ______________ CA in transplant patients has increased ~ due to loss of protective effects of and active ________ _______.

A
  • lymphoproliferative

- immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What immunosuppressive regimans have increase success of transplantation?

A
  • Cyclosporine (1980)
  • Azathiopine
  • OKT3
  • Steroids ~ prednisone and methylprednisolone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F: Success of transplantation of an organ due to increase donor:recipient tissue typing.

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What factors play a role in post transplantation organ function?

A
  • Donor demographics
  • Organ ischemic time
  • Mechanismof death of donor
  • Medical condition of recipient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the major indications for Kidney transplantation?

A

-Diabetes mellitus
-Hpertension induced nephropathy
-Glomerulonephritis
Polycystic kidney Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the graph survival rate of a kidney at 5 years that are living donors?

A

81%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What preparation is needed for transplant?
- Cardio pulmonary - Extent of renal failure - Electrolyte balance being normal - Questionable preoperative renal dialysis - normal volumes
26
What physiologic disturbances often present before RENAL transplantion?
-Peripheral neuropathy -Lethargy -Anemia -Platelet dysfunctin -Pericarditis -Systemic hypertension -Depressed ejection fraction -Pleural effusions Skeletal muscle weakness -ileus -Glucose intolerance
27
What type of anesthesia will most likely be given for renal transplantation?
-General
28
What is the optimal fluid status and renal perfusion?
-CVP ~ 10 - 15 mmHg
29
Anesthesia management for renal transplantation is?
- Stimulation decreases after dissection of fascia - Avoid hypotension(could be relative due to much opiod use) - do not use a ALPHA ADRENERGIC drugs because transplant kidney is sensitive to it.
30
How would you maintain renal perfusion pressure and enchance urine production
- Mannitol | - Loop Diuretics
31
T/F: Dopamine is a good way to maintain you anesthesic.
FALSE
32
Prompt urine production is occurs at __% with living donor transplant and __% decrease donor transplant.
- 90 | - 40-70
33
If urine output is decreased after renal transplant what could it mean?
- May indicate mechanical impingement of graft, anastamosing vessel, or ureter. - Intraoperative ultrasounay
34
What vitals may be prominent on emergence of a renal transplant patient and what would be done?
- Ranal transplant | - Start anti hypertensive drugs
35
What type of pain will a renal transplant patient have?
- Mild to moderate | - Controlled by IV opiods
36
T/F: Epidural catheters a used in the management of renal transplant patients.
FALSE
37
Will renal transplant patients still suffer from primary systemic diseases (DM, HTN, etc..).
YES
38
What will occur with renal excretion of drugs with a renal transplant patient?
-It will be decreased than that of a person with native kidneys.
39
What is the 10 year survival rate of a liver transplant?
~ 60%
40
What are indication for a liver transplant?
- End Stage Liver Disease with Life Threatening Complication - Acute Hepatic Necrosis - Chronic Hepatitis - Cholestatic Disease - Alcoholic Cirrhosis - Metaboic diseases - Malignant disease of liver
41
What might be the effect of ACUTE HEPATIC NECROSIS?
- Viral hepatitis - Drug toxicity - Toxins - Wilson's disease
42
What might be the effect of CHRONIC HEPATITIS?
- B,C,D - Autoimmune hepatitis - Chronic drug toxicity - Cryptogenic cirrhosis
43
What might be the effect of CHOLESTATIC DISEASE?
- Primary/secondary biliary cirrhosis - Sclerosing cholangitis - Biliary Atresia - Cystic fibrosis
44
Would an alcoholic ever be considered for a liver transplant?
-Yes, if abstinence for alcohol for 6 month with ongoing treatment and evaluation
45
What might be the effect of malignant disease of liver?
- Hepatocellular carcinoma - Carcinooid tumor islet cell tumor - Epithelioid hemangioendothelioma
46
Patient's with chronic liver dysfunction and cirrhosis have a ________ circulation with _____ peripheral vascular resistance and an _______ cardiac index.
- hyperdynamic - low - increased
47
T/F: The cause of hepatic encephalopathy is believed to be multifactorial.
TRUE
48
Liver failure would cause what to the central nervous system?
- Hepatic encephalopathy | - Increased intracranial pressue (acute liver failure)
49
Liver failure would cause what to the cardiac system?
- Hyperdynamic circulation | - Cirrhotic cardiomyopathey
50
Liver failure would cause what the the respiratory system?
- Hepatopulmonary sysndrome (ARTERIAL HYPOXIMIA | - Portopulmonary hypertension
51
Liver failure would cause what to the gastrointestinal system?
- Portal HTN - Upper gastrointestinal bleeding - Ascites
52
Liver failure would cause what to the hematologic system?
- Anemia - Thrombocytopenia - Prolonged prothrombin time and plasma thromboplastin time - Decreased plasma fibrinogen concentration - Disseminated intravascular coagulation - Protein C and S deficiencyL
53
Liver failure would cause what to the Renal symptoms?
- Hepatorenal syndrome | - Acute tubular necrosis
54
What is the preanhepatic phase?
- Dissection phase | - Incision and access to the liver is obtained
55
What is the anhepatic phase?
-Liver is isolated from the circulation >Removal of native liver >Implantation of donor liver
56
What is the neohepatic phase?
New liver is reperfused >Surgical completion of remaining anastamosis >Hemostasis >Closure
57
What anesthesia management is done during the prehepatic phase?
- Hemorrhage concern - Venous pooling associated with sudden decrease in intraabdominal pressue - Impaired venous return from surgical retraction - Hypocalcemia - Hyperkalemia - metabolic acidosis
58
What anesthesia managment is done during the anhepatic phase?
- Cardiac output and systemic blood pressure may need to be supported with inotropes and vasopressors. - Venovenous bypass may be used to minimize the reduction in preload, cardiac output and to prevent splanchnic congestion. - Citrate intoxication may occur from rapid infusion of large volumes of blood in absence of liver function. - Calcium administration if patient is hypocalcemic
59
What anesthesia is done during the neophepatic phase?
- Severe hemodynamic instability may occur with unclamping of portal vein (reperfusion syndrome) - May need potent vasopressors - Hemodynamic typically stabilize once allograft begins to function
60
What are some initial indirect signs the graft is working?
- Intraoperative bile production - Intraoperative spontaneous correction of negative base excess - Improvement in coagulation
61
What are the most frequent indications for lung transplantation?
- Chronic obstructive pulmonary disease - Idiopathic pulmonary fibrosis - Cystic fibrosis - Antitrypsisn deficiency - Sarcoidosis - Congenital heart disease (Eisenmenger's syndrome with concomitatnt cardiac repair)
62
Lung transplant stabilizing measure are aimed at improving cardiac output?
- IV inotropes - Intra aortic ballon pump - Ventricular assist device - Mechanical ventilation

Levi's Class 2014 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions