ABSITE ch 12 transplant.txt

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ABSITE ch 12 transplant.txt
2010-01-15 10:05:07
transplant ABSITE

ABSITE ch 12 transplant
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  1. HLA types most important in recipient/donor matching
    HLA-A, HLA-B, and HLA-DR**
  2. Transplant type that does not require ABO blood compatibility
  3. Test that detects preformed recipient antibodies by mixing recipient serum with donor lymphocytes
  4. Technique identical to crossmatch that detects preformed recipient antibodies using a panel of typing cells
    PRA (panel reactive antibody)
  5. Treatment of mild organ rejection
    Steroid pulse
  6. Treatment of severe or secondary organ rejection
  7. Most common malignancy following transplant
    Skin cancer (SCCA)
  8. Most common non-skin malignancy following transplant
    PTLD (post-transplant lymphoproliferative disorder)
  9. Virus related to most PTLD incidence
  10. Transplant drugs that inhibit de novo purine synthesis and thus, T-cells
    Azathoiprine, mycophenalate
  11. Active metabolite of azathioprine
  12. transplant drug that binds cyclophilin protein and inhibits cytokine synthesis
  13. side effects of cyclosporine (5)
    nephrotox, hepatotox, HUS, tremors, seizures
  14. transplant drug that binds FK binding protein; similar mechanism to cyclosporine but 100X more potent
    FK-506 (tacrolimus)
  15. Side effects of tacrolimus (FK506, Prograf)
    Nephrotox, mood change, GI
  16. Equine polyclonal antibodies directed against antigens on T cells used for transplant induction therapy
  17. Rabbit polyclonal antibodies directed against antigens on T cells, used for transplant induction therapy
  18. Monoclonal antibodies that block T cell antigen recognition by binding CD3
  19. Side effects of OKT3
    Fever, chills, pulmonary edema, shock
  20. Human monoclonal antibody against IL-2, used in transplant induction and to prevent rejection
  21. Rejection caused by preformed antibodies, activating complement cascade and thrombosis of vessels
  22. Rejection caused by sensitized T cells to donor antigens
    Accelerated rejection
  23. Rejection caused by T cells (cytotoxic and helper)
    Acute rejection
  24. Treatment of hyperacute rejection
    Emergent retransplant
  25. Treatment of acute and accelerated rejection
    Steroids, inc immunosuppression, OKT3
  26. Rejection caused by antibody formation, type IV hypersensitivity with sensitized T cells
    Chronic rejection
  27. Treatment of chronic rejection
    Inc immunosuppression (no real effective treatment)
  28. Acceptable cold time for a kidney
    48 hours
  29. typing needed for kidney transplant
    ABO, crossmatch
  30. Primary perioperative mortality of kidney transplant
    MI, stroke
  31. Complications of kidney transplant (acute)
    Urine leak, renal artery stenosis, lymphocele
  32. Sign of renal vein thrombosis post-transplant
    New proteinuria
  33. Common posttransplant viral infections of the kidney
    CMV, HSV
  34. 5 year kidney graft survival
    70% (cadaveric 65%, living donor 75%)
  35. most common complication of kidney donation
    wound infection
  36. most common cause of death after kidney donation
  37. Acceptable cold time for a liver
    24 hours
  38. tests needed for liver transplant
  39. most common reason for liver transplant in US
    chronic hepatitis
  40. criteria for emergent transplant
    stupor, coma associated with liver failure
  41. liver tumors acceptable to transplant
    HCC (single tumor <5cm or up to three tumors each <3cm)
  42. Best predictor of 1-year survival after liver transplant
    APACHE score
  43. Disease most likely to recur in new liver allograft
    Hep C
  44. Method to reduce Hep B reinfection rate
    HBIG, lamivudine
  45. Extracellular fat globules in a liver allograft that can predict primary nonfunction
  46. Most common arterial anomaly in liver
    Right hepatic artery off SMA
  47. Complications of liver transplant (acute) (6)
    Bile leak, primary nonfunction, hepatic artery thrombosis, abscess, IVC stenosis, cholangitis
  48. Complications associated with microscopic findings of portal lymphocytosis, endothelitis, bile duct injury
    Acute rejection
  49. Complications associated with microscopic findings of disappearing bile ducts, portal fibrosis
    Chronic rejection
  50. Retransplantation rate after liver transplant
  51. 5-year survival rate after liver transplant
  52. vessels needed with pancreas allograft for hookup
    donor celiac, SMA artery, donor portal vein
  53. most common drainage of pancreatic exocrine secretions
    enteric (donor duodenum to recipient bowel)
  54. complications of pancreas transplant (2)
    thrombosis, rejection
  55. signs of pancreas transplant rejection
    inc glucose, amylase, trypsin, fever
  56. acceptable cold time for hearts
    6 hours
  57. tests needed to determine heart match suitability
    ABO, crossmatch
  58. Most common cause of early mortality following heart transplant
    Reperfusion injury
  59. Indications for double lung transplant
  60. Pathologic finding associated with acute lung transplant rejection
    Perivascular lympocytosis
  61. Pathologic finding associated with chronic lung transplant rejection
    Bronchiolitis obliterans
  62. Common viral infections post-transplant (3)
  63. Common protozoal opportunistic infections post-transplant (1)
    Pneumocystis jeroveci (P. carnii) pneumonia
  64. Common fungal opportunistic infections post-transplant (3)
    Aspergillus, candida, Cryptococcus
  65. Reason for bactrim prophylaxis following transplant
    Prevent PCP pneumonia