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Transplant Surgery

This document provides information about organ transplantation including definitions, types of transplants, indications for transplantation, the transplantation process, post-transplant immunosuppression, complications, and the role of physiotherapy in patient rehabilitation. Organ transplantation is a medical procedure where an organ is removed from one body and placed into another to replace a damaged or missing organ. The transplantation process involves screening of both the donor and recipient for compatibility and risk factors before scheduling the transplant surgery. After transplantation, immunosuppressant drugs are used to prevent rejection of the new organ by the recipient's immune system. Complications can include rejection, infection, and other issues related to the surgery or long-term immunosuppression. Physiotherapy aims to prepare patients for

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47 views8 pages

Transplant Surgery

This document provides information about organ transplantation including definitions, types of transplants, indications for transplantation, the transplantation process, post-transplant immunosuppression, complications, and the role of physiotherapy in patient rehabilitation. Organ transplantation is a medical procedure where an organ is removed from one body and placed into another to replace a damaged or missing organ. The transplantation process involves screening of both the donor and recipient for compatibility and risk factors before scheduling the transplant surgery. After transplantation, immunosuppressant drugs are used to prevent rejection of the new organ by the recipient's immune system. Complications can include rejection, infection, and other issues related to the surgery or long-term immunosuppression. Physiotherapy aims to prepare patients for

Uploaded by

Stephenson Macharia
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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TRANSPLANT

SURGERY
Upgrading Group
Omar Heba HSM221-0528/2022
Joseline Mwangudza HSM221-0529/2022
Felix Ochieng HSM221-0507/2022
DEFINITIONS
Organ transplantation- Medical procedure in which an organ is removed from
one body and placed into the body of another to replace a damaged or missing
organ.
Donor- This is a person who provides an organ/blood/tissue for transplantation
1. Living and related to the patient
2. Living and unrelated to the patient
3. Deceased donor
Recipient- A person who receives blood tissues, cells or an organ from another
person.
TYPES OF TRANSPLANTS
Transplanted tissues may be:
1. Cells- hematopoietic stem cells
2. Parts or segments of an organ - liver, skin grafts
3. Entire organ – heart, kidney
4. Tissues – cornea
Transplant may also be
5. Autografts- Patients own tissue
6. Isograft- Genetically identical donor tissue[between monozygotic twins]
7. Allografts -Genetically dissimilar donor tissue
8. Xenografts- Tissue from a different species
INDICATIONS
1. Deteriorating organ function - chronic kidney disease, heart failure with
prognosis of one year to live
2. Congenital heart malformation
3. Cancer –Renal tumours, liver tumours, haematological cancers
4. Inherited disorders- cystic fibrosis, sickle-cell anaemia
5. Metabolic disorders- Wilson disease
6. Extensive burns
7. Trauma
TRANSPLANTATION PROCESS
Pre- transplantation screening
1. Both donor and recipient undergo medical and psychological screening and lab studies
to evaluate risk of both active and latent infections[TB, Hepatitis B,C and HIV]
2. They are also tested for tissue compatibility through HLA[Human leucocyte antigens]
tissue typing and blood grouping
3. The recipients also have to meet an eligibility criteria that varies from region to region
and is determined by the governing body
4. Once the prerequisites are met the transplant surgery is normally scheduled and done
NB; Warm ischemic time – the time from death or organ removal to cold perfusion
Cold ischemic time – time from cold perfusion to anastomosis
CONT…
Post-transplantation immunosuppression
When organs are transplanted a series of cellular and molecular events are initiated
involving reperfusion injury, innate and adaptive immune responses. These undesirable
responses are blunted by the use of immunosuppressants which include
1) Steroids
2) Immunophilin binding agents- cyclosporine
3) Inhibitors of nucleotide synthesis-MMF[Mycophenolate Mofetil]
4) Antimetabolites –azathioprine
5) Immunosuppressive immunoglobulins
6) Irradiation esp in kidney transplant rejection
COMPLICATIONS
Rejection
1. Hyperacute- occurs within minutes to hours
2. Acute – occurs during the first 6 months of transplantation
3. Chronic – occurs after 6 months of transplantation
Graft vs Host disease
Immunosuppression complications like opportunistic infections, osteoporosis, growth retardation in
children
Cancer
Complications of surgery like bleeding, surgical site infections
Anaesthetic complications – allergic reactions
NB; Other complications are organ specific.
ROLE OF PHYSIOTHERAPY IN PATIENT
REHABILITATION

Pre-op care
1. Breathing exercises
2. Compression stockings
3. Issuance and teaching of incentive spirometry
Post-op care
4. Early mobilization – to prevent DVT and maintain muscle mass
5. Breathing exercises- to achieve full lung functions n prevent infection
6. Secretion clearance
7. Postural transfers and in-bed patient positioning
8. Monitoring – oxygen levels, perceived exertion scale.

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