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Flashcards in Transplantation 2 Deck (17)
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1
Q

Rejection within minutes

A

Hyperacute

2
Q

What is acute rejection?

A

Early rejection, T cell or B cell mediated response

-Can be treated with increased immunosuppression

3
Q

Name 2 calcineurin inhibitors

A

Cyclosporin, tacrolimus

4
Q

How do calcineurin inhibitors work?

A

Inhibit activation of T helper cells (NK cells, cytotoxic cells, decrease cytokine release - prevent B cell proliferation)

5
Q

Side effects of calcineurin inibitors

A

Renal dysfunction
Hypertension
Diabetes
Tremors

6
Q

What is chronic reaction?

A

Antibody-mediated vascular damage (months to years, controversial)

7
Q

How do azathioprine and mycophenalate work?

A

Suppression of proliferation of B cells (block purine synthesis)

8
Q

Side effects of azathioprine and mycophenolate?

A

Leucopaenia Anaemia

GI side effects

9
Q

Leucopaenia
Anaemia
GI side effects

A

Azathioprine and mycophenolate

10
Q

Renal dysfunction
Hypertension
Diabetes
Tremors

A

Calcineurin inhibitors

11
Q

How do steroids work?

A

Suppress activity of T cells

Suppress proliferation of B cells

12
Q

Is vasculitis a contra-indication to kidney transplant?

A

Active vasculitis is a contra-indication

13
Q

Absolute contraindications to kidney transplant

A
Malignancy
Known untreated malignancy
Hx of solid tumour within 2 years (For some tumours 5 years)
Untreated TB
Severe IHD not amenable to surgery (should be carried out prior to Tx)
Severe airways disease
Active vasculitis
Severe PVD (Unusable vessels)
14
Q

What is the surgery like for kidney transplantation?

A

procedure
Usually 3-4 Hours
Stent inserted between ureter and bladder
Wound 15-20 cm long

15
Q

Surgical complications

A
Bleeding (arterial or venous)
Arterial Stenosis / Thrombosis
Venous stenosis / Thrombosis
Ureteric Stricture and hydronephrosis
Wound infection
16
Q

How to tell if the graft is working

A

The urine output will be good and the creatinine will fall

17
Q

What is delayed graft function?

A

You develop acute tubular necrosis after transplant
You will need haemodialysis for a bit
BUT your transplant will work 10-30 days after