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Liver Transplant
Liver Transplants and Organ Donation
| Question | Answer |
|---|---|
| One organ donor can save or enhance the lives of more than: | 25 people |
| There are two types of organ donors, what are they? | Ventilated patients (heart beating donors) and non-ventilated patients |
| These types of organ donors are typically otherwise healthy individuals who sugger a major trauma whether it be a gun shot , motor vehicle accident, or some type of trauma that causes them to eventually have no more hope. | Ventilated patients (heart beating donors) |
| Basically, heart beating donors are: | Kept alive on a ventilator and are brain dead. |
| The general rule is that organs and tissues come from: | heart beating donors |
| Why would you not take organs from non-heartbeating donors? | Becaue if they don't have ventilation and perfusion, the organs cannot be used. Only the tissues. |
| What ages are heartbeating donors? | Newborn to years |
| Heartbeating donors must have an absence of? | HIV, HBV, cancer other than primary brian tumors. |
| What organs are donatable with heartbeating donors? | Heart,lungs, liver, pancreas, kidneys, small bowel. |
| What tissues are donatable with heartbeating donors? | Bone, Corneas/eyes, heart valves, saphenous veins, and skin |
| What is the priority for consent if a person is not registered as a donor? | POA for health care agent, spouse, daughter or son over 18, either parent, brother or sister over 18, and then legal guardian. |
| How is hydration and perfusion of the body maintained after consent and death is pronounced? | BP is mainteded at >100, dopamine and dobutamin to keep perfusing, CVP line is inserted, Maintain urine output between 1-3 cc/kg/hr, replace urine output with D 5.45 NS + 20 mEq KCl or othe rfluid indicated by electrolytes. Administer PRBCs for Hct <25 |
| How is oxygenation of the body maintained after consent and death is pronounced? | Increase FIo2 and utilize PEEP to maintain PO2>80 and O2 saturation> 95%. |
| How is Temperature Control of the body maintained after consent and death is pronounced? | Maintain and use warming blanket or heat lamp as needed. |
| What tow main things do the patient who has had a liver transpant have to live with? | The risk of infection, and the risk of rejection. |
| These donors are patients who signed up a s organ donors, but theey don't suffer a traumatic injury and are not kept on a ventilator. | Non ventilated patients |
| What is the nursing role in dealing with a non ventilated patient? | Maintain the corneas by administering ocular care. Tape eyelids shut, lift the head, Cool the eye region by applying a small ice pack. |
| The number one reason for adult liver transplant is: | Hepatitis C with alcoholic liver disease. |
| What are some reasons for transplant of a liver? | Cholestatic disease, and primary biliary cirrhosis. |
| What is the main reason for pediatric liver transplants? | Biliary atresia |
| What is autoimmune hepatitis? | The body makes antibodies against its own liver. |
| What is the goal of drugs used after a liver transplant? | To prevent transplant rejection |
| What kind of drugs are used to prevent transplant rejection? | Immunosuppressant drugs |
| The patient is put on this drug to inhibit IL2 release from CD4 cells and is capable of drug interactions. | cyclosporin |
| This drug that is administered following liver transplant surgery is nephrotoxic,it can damage the kidneys. | cyclosporin |
| the primary drug post liver transplant to PREVENT REJECTION. | cyclosporin |
| To minimize sides effect of cyclosporin, they use adjunct drugs. What do adjunct drugs do? | They work together with or help out the cyclosporin |
| This adjunct drug suppressess delayed hypersensitivity and anti-body response. | Azathioprine (Immuran or Cellcept) |
| This medication is basically for when the CD4 cell or T$ lymphocyte sends out a message that there's a problem and it inhibits that. | Cyclosporin |
| This medication works a little bit later on and suppresses hypersensitivity ro antibody formation. | Azathioprine |
| This is the only agent for REVERSAL of rejection. | OKT3 |
| When a patien exhibits early signs of rejection, they receive this medication. | OKT3 |
| Early symptoms and signs of rejection may be: | flu-like with fever, chills etc. |
| Post transplant, what kind of care do the patients have to have? | Monitor for signs of infection or rejection. Monitor for kidney function. |
| What does the patient who has liver transplant need to be taught after the surgery? | They will be on anti-rejections drugs, they are immunosuppressed so they are at a rick for infection. Good handwashing is important as are all the things you teach patients with chronic diseases. Such as avoid crowds. |
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