OrganNumber waiting list Dec 08Number Transplant 07/08 Kidney94802462 Liver335718 Pancreas83224 Heart111127 Lung242139 Total10,2643478.

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Presentation transcript:

OrganNumber waiting list Dec 08Number Transplant 07/08 Kidney Liver Pancreas83224 Heart Lung Total10, solid organs

Hyperacute rejection

Histology of acute cellular rejection

Vasculitis

Chronic rejection with tubulointerstitial lesions

Fibrointimal proliferation in renal arterioles in chronic rejection

Assessment As per donor tests + Full hx/exam: recent infections Pre-tx dental assessment Cardiac evaluation: echo/stress test Organ specific criteria/factors eg OLT for ALD Any other test indicated

ESRD/CRF eg hyperT, diabetic nephropathy, chronic GN, polycystic kidneys Kidney Acute/Fulminant Liver Failure: Viral (seronegative), Paracetamol OD, Drug reactions, Primary non-function transplant, Wison’s disease ESLD/cirrhosis: PBC, PSC, ALD, Viral B&C, NASH, AIH Liver Type 1 /IDDM Intestinal failure: short gut syndrome, post surgery for thrombotic disorders, trauma. Pancreas Small Bowel

End-stage heart failure Severe CAD Heart emphysema, pulm fibrosis, AAT, Cystic fibrosis pulmonary hypertension Lung Congenital problems affecting heart and lungs Pulmonary hypertension, cystic fibrosis Heart-lung

KidneyLiverPancreas Renal Artery Thrombosis or stenosis Renal Vein thrombosis or stenosis Urinary leak or UV stenosis, urological obstruction Lymphocoele Hepatic Artery Thrombosis Portal vein thrombosis SVC/IVC stenosis Bile leak Biliary stenosis/obstruction Pancreatic leak Graft Pancreatitis Vascular thrombosis Haematuria/cystitis for bladder drained grafts Metabolic disturbances KP tx – see kidney

Graft: 90% 1 yr & 80-84% 5 yr Patient: 95-97% 1 yr & 88% 5 yr Kidney Graft: 82-85% 1 yr & 65% 5 yr Patient: 90% 1 yr & 76% 5 yr Liver Graft: 87% 1 yr & 50-70% 5 yr Patient: 95-97% 1 yr & 85% 5 yr Pancreas

Graft: 68% 1 yr & 36% 5 yr Patient: 80% 1 yr & 56% 5 yr Small bowel Graft: 83% 1 yr & 50% 5 yr Patient: 83% 1 yr & 54% 5 yr Lung Graft: 85% 1 yr & 70% 5 yr Patient: 85% 1 yr & 73% 5 yr Heart