Final Prep - Organ Transplant Flashcards


Recipient Requirements

have renal disease have desire to have transplant
willing to be educated
be compliant


Deceased
Donor Transplant

85-90% success do transplant within 4-24hr
notify transplant office if change in location, out of town


Living Donor Transplant

95% success family donors, siblings = best match
less rejection & infection no waiting list, can
schedule


ABO Blood Typing

O - gets from: O, gives to: all/universal AB - gets
from: all/universal, gives to: AB A - gets from: A & O,
gives to: A & AB B - gets from: B & O, gives to B
& AB


Recipient Evaluation

full assessment BMI 20-35 drug-free at least
3mo can pay for meds blood draw 2x/mo


Tissue Type Factors

HLA: higher # = better (# of antigens) PRA: lower % =
better (% of people will react to)


Kidney
Transplant Surgery

original kidney not removed transplanted kidney placed
in front above pelvic bone


Kidney
Transplant Post-Surgery

1st 24hrs:
strict I&Os pain control up &
walking within 4hrs


Transplant Meds

NEVER stop or miss meds on your own - most common cause of
organ rejection/loss be knowledgeable don't take
other meds w/o consult w/ transplant surgeon notify HCP
you're a transplant recipient take same time every day


Transplant
Meds - Immunosuppressants

prednisone neoral prograf (easily toxic,
blood draws) rapamune imuran
cellcept thymoglobulin solu-medrol
Radiation Tx OKT3-muromonab - CD3


Transplant
Meds - Immunosuppressants

Common Side Effects

N/V/D ab pain, indigestion, dec. appetite
joint aches inc. BP inc. cholesterol


Transplant
Maintenance Meds

calcineurin inhibitor (cyclosporine, tacromilus)
purine antagonist (azathioprine, mycophenylate) mTOR
(sirolimus)


Transplant Complications

bleeding thrombus anastomosis problems
delayed function infection donor-related
issues


Transplant Rejection

Most transplant pts. will have at least 1 episode of
rejection 1st 3mo. are riskiest doesn't mean organ
needs removal rejection Tx drugs


Transplant
Rejection Sx

fever >100 flu-like Sx dec. UOP
inc. weight tender, red, heat over transplant area
inc. creatinine


Transplant
Rejection Meds

Thymoglobulin Solumedrol Radiation Tx
OKT3-Muromonab - CD3