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Liver Transplant

Liver Transplants and Organ Donation

QuestionAnswer
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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