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Terms in this set (240)
Anastomosis of the inferior vena cava, portal vein,
Procedure for liver
hepatic artery, and the biliary connection via a duct to
transplant
duct anastomosis ( choledochocholeclochostomy)
Etiology of renal Hypotensive episodes, blood loss, high renal vein
dysfunction immediately pressure intraoperatively and postoperatively due to
post op(liver tx) hemodynamically instability or sepsis.
Leading cause of non Cardiorespiratory failure
graft related death for
liver recipients
Which Calcineurin inhibitors or corticosteroids
immunosuppressants
cause HTN
Which lab to monitor with Crp- c reactive protein because protein present with
fever post tx acute inflammation and sepsis
Indicative of rejection Light stools and dark urine,
Indicative of poor graft High lactate and acidosis, high ALT/AST, PT >25 sec
function s/p liver and continues to rise after vit k and FFP
transplant
More common, occurs in adulthood, characterized by
insulin resistance. As resistance rise, beta cells are
type 2 diabetes eventually unable to produce necessary amount of
insulin to lower and maintain normal blood glucose
levels.
diabetes in which no beta-cell production of insulin
type 1 diabetes mellitus occurs and the patient is dependent on insulin for
survival
, Type 1 DM manifested by poor metabolic control,
Indications for pancreas especially hypoglycemic unawareness for many years.
transplant alone (PTA) or On insulin and C-peptide at or < 2 ng/ml or on insulin
pancreas after kidney and C-peptide at or greater than 2ng/mg and BMI at
(PAK) transplant or less than maximum allowable BMI (currently 28)
and pancreatic exocrine insufficiency.
Indications for Diagnosis of diabetes or pancreatic exocrine
Simultaneous pancreas- insufficiency with renal insufficiency
kidney (SPK) transplant
Immunosuppressive Medicare part B
medications are covered
by which part of
Medicare?
Standard Tacrolimus(prograf, FK506), mycophenolate mofetil
immunosuppressive for (cellcept), prednisone(steroid)
pancreas transplant
recipients typically
includes:
Reason why native Allows the exocrine function of native pancreas to be
pancreas left in place preserved.
during pancreas tx
More common, difficult to detect rejection, donor
portal vein anastomosed to recipients SMV(superior
Enteric Drainage( ED) post
mesenteric vein), donor duodenal segment attached
pancreas transplant
to recipients jejunum, pancreases produces 2L of fluid
drainage, pancreatic enzymes excreted thru the stool
Advantages of Enteric More physiologic, fewer metabolic imbalances
drain (ED) post pancreas because pancreatic secretions are reabsorbed, less
transplant post-op complications
Easier to monitor for rejection with urine amylase, may
Bladder Drainage (BD) cause dehydration and cystitis. Direct monitoring of
post pancreas transplant graft exocrine function, easier to perform biopsy, less
invasive if complications arise.
Disadvantages of Bladder Dehydration, cystitis, UTIs, metabolic acidosis, urine
Drainage (BD) post leak, hematuria, 35% go on to need enteric
pancreas transplant conversion, pancreatitis
Patients with anastomotic Elevated serum amylase levels