Term
| Primary cell mediator of graft vs. host disease |
|
Definition
|
|
Term
| Mechanism of hyperacute rejection and management |
|
Definition
| pre-formed antibodies; avoid transplant when crossmatch is positive; emergent retransplant |
|
|
Term
| Mechanism of acute rejection and management |
|
Definition
| foreign MHC Ags of graft cells; tx with OKT3, pulse steroids |
|
|
Term
| Histologic appearance of acute rejection |
|
Definition
|
|
Term
| Mechanism of chronic rejection and management |
|
Definition
| gradual loss of blood supply; no treatment |
|
|
Term
| Facet of immune system involved in immunosuppression |
|
Definition
| Cell-mediated (which is why viral risk is higher than bacterial and also why there is an increase in CA- skin, leukemia, lymphoma, cervical) |
|
|
Term
| MC viral infection post-transplant and tx |
|
Definition
|
|
Term
|
Definition
| # 6-MP derivative that is a purine analog and acts as an anti-metabolite; effect is decreased DNA synthesis which inhibits T cells |
|
|
Term
| MOA of mycophenolate (cellcept) |
|
Definition
| # blocks purine synthesis to decrease T and B cell proliferation |
|
|
Term
| MOA of cyclosporine and main side effect |
|
Definition
inhibits mRNA encoding IL-2, IL-3, IL-4 and INF-gamma
Nephrotoxic, hepatotoxic, HUS, tremors and seizures |
|
|
Term
|
Definition
| Blocks IL-2 expression/production from T cells |
|
|
Term
|
Definition
| Blocks IL-1 from macrophages |
|
|
Term
| Likely cause of biliary stricture post liver txplant |
|
Definition
| ischemia, check hepatic artery flow |
|
|
Term
| MCC of oliguria s/p renal txplant |
|
Definition
|
|
Term
| 1 year survival s/p cardiac txplant |
|
Definition
|
|
Term
| 1 year survival s/p liver txplant |
|
Definition
|
|
Term
| Most important MHC gene in recipient/donor matching |
|
Definition
| HLA-DR (A and B are also important) |
|
|
Term
| 2nd MC malignancy post txplant and management |
|
Definition
# Postransplant lymphoproliferative d/o
# stop immunosuppression; may need chemo and RT |
|
|
Term
| Metabolism and clearance of cyclosporin |
|
Definition
| Hepatic metabolism and biliary excretion |
|
|
Term
|
Definition
# monoclonal Ab that blocks Ag recognition function of T cells by binding CD3
# interferes with MHC I and II |
|
|
Term
| Mechanism of accelerated rejection and management |
|
Definition
(Occurs < 1 week)
# caused by cytotoxic and helper T cells
# increase immunosuprression, pulse steroids and possible OKT3 |
|
|
Term
| MCC of mortality of kidney txplant patients |
|
Definition
|
|
Term
| MC complication after kidney transplant and management |
|
Definition
Urine leaks
# Tx is drainage and stenting, many need reoperation |
|
|
Term
| DX and management of renal artery stenosis post-transplant |
|
Definition
# Dx with ultrasound
# PTA with stent |
|
|
Term
| MCC of extrinsic compression on txplaned kidney and management |
|
Definition
# lymphocele
# percutaneous drainage, if that doesn't work- then intraperitoneal marsupialization |
|
|
Term
| Management/work-up for kidney rejection |
|
Definition
# first do ultrasound to r/o vascular problem or ureteral obstruction; Bx may be necessary
# decrease cycolsporin or FK because they are nephrotoxic and pulse steroid |
|
|
Term
| Presentation of kidney rejection |
|
Definition
|
|
Term
| MC cause of death of a living kidney donor |
|
Definition
|
|
Term
| MC complication for a living kidney donor |
|
Definition
|
|
Term
| 5-year graft survival of kidneys |
|
Definition
| 70% overal; 65% for cadaveric and 75% for living donor |
|
|
Term
| Contraindications for liver txplant |
|
Definition
| current EtOH abuse, acute UC |
|
|
Term
| MC reason for liver txplant |
|
Definition
|
|
Term
| criteria for emergent liver transplant |
|
Definition
| Stage III (stupor) or stage IV (coma) |
|
|
Term
| Management of HBV in patients s/p Liver transplant |
|
Definition
| HBIG and lamivudine (protease) inhibitor |
|
|
Term
| Best predictor of 1-year survival in liver transplant |
|
Definition
|
|
Term
| MC complication after liver transplant and management |
|
Definition
# bile leak
# PTC tube and stent |
|
|
Term
| #1 cause of early mortality s/p lung txplant |
|
Definition
|
|
Term
| Histologic appearance of chronic rejection of lung txplant |
|
Definition
|
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