Transplant Protection and Immunosuppression

These flashcards cover key concepts and details about transplant indications, procedures, immunosuppression, complications, and management.

What are the indications for lung transplants?

Lung disease with death within 2 years, cystic fibrosis, cancer with less than 2 years to live, diseases of another system like heart or renal disease, severe obesity, and tuberculosis.

What is the purpose of preoperative outpatient pulmonary rehabilitation for lung transplants?

To prepare patients for surgery and improve their lung function.

What are common postoperative complications after lung transplantation?

Infections, diaphragm dysfunction, venous thromboembolism, cancer, bronchitis, and pneumonia.

What is used as a three-drug regimen for immunosuppression in lung transplants?

Tacrolimus (calcineurin inhibitor), mycophenolate (antiproliferative), and prednisone.

What are the signs of acute rejection in lung transplants?

Low grade fever, dyspnea, dry cough, and desaturation.

How is acute rejection diagnosed?

By biopsy via bronchoscopy.

What is bronchiolitis obliterans syndrome?

A progressive chronic rejection characterized by airflow obstruction and nonproductive cough not responsive to bronchodilators or steroids.

What are the indications for heart transplants?

End-stage heart disease, severe heart valve disease, and severe dysrhythmias refractory to treatment.

What tests are performed to diagnose rejection in heart transplants?

Endomyocardial biopsy is performed weekly for the first month, then monthly for the next six months, and then yearly.

What are the risk factors for kidney transplant rejection?

Advanced cancer, refractory heart disease, chronic respiratory failure, chronic infections, and substance abuse.

What is the typical post-operative care for kidney transplant donors?

Monitor renal function, manage pain, and monitor for signs of rejection.

What are common post-transplant complications for all types of transplants?

Infection (e.g., pneumonia, UTI), cardiovascular disease, and cancer.

What is the role of corticosteroids in immunosuppression?

Corticosteroids help to reduce inflammation and prevent rejection, but can increase infection risk.

What is hyperacute rejection?

A rare type of rejection that occurs within 24 hours due to pre-existing antibodies against the transplant.

What treatments are available for chronic rejection?

Supportive management, as there is no definitive treatment, but corticosteroids and other immunosuppressants can be employed.

What are the common immunosuppressants used after liver transplants?

Corticosteroids, tacrolimus, and azathioprine.

What is the most common cause of death after organ transplantation?

Cardiovascular disease.