Clinical Correlation: Transplantation

Question 1

what are the two kinds of transplant surgery and examples of each?

Answer 1

• heterotopic: kidney, pancreas

- orthotopic:lung, liver, kidney

Question 2

Describe: Induction therapy vs. maintenance therapy:

Answer 2

induction therapy:

• monoclonal Ab or polyclonal Ab or none: basiliximab or thymoglobulin
• higher doses of maintenance agents

maintenance therapy:

• primary agent: calcineurin inhibitor: tacrolimus or cyclosporine
• antiproliferative agent: mycophenolic acid or azathioprine or sirolimus
• steroids

Question 3

List the means of monitoring a patient post-tx:

Answer 3

• immunosuppression
• tests of funx : pulmonary funx, serum creatinine
• signs of organ damage: enzymes
• imaging of organ
• tissue examination: biopsy

Question 4

what are the common findings in chronic allograft disease?

Answer 4

• interstitial fibrosis
• parencyhmal atrophy
• obliterative arteriopathy (loos of blood vessels)

Question 5

What diseases/conditions are tx patients at higher risk for?

Answer 5

• malignancy
• metabolic disease
• renal failure (non-renal tx)
• bone disease: osteopenia nand osteoporosis, avascular necrosis
• reproduction (note: some immunosuppressives are teratogenic)

Question 6

complications of tx include:

Answer 6

• acute rejection
• chronic graft dysfunction
• infection
• malignancy
• medical complications