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

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Presentation on theme: "OrganNumber waiting list Dec 08Number Transplant 07/08 Kidney94802462 Liver335718 Pancreas83224 Heart111127 Lung242139 Total10,2643478."— Presentation transcript:

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

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28 Hyperacute rejection

29 Histology of acute cellular rejection

30 Vasculitis

31 Chronic rejection with tubulointerstitial lesions

32 Fibrointimal proliferation in renal arterioles in chronic rejection

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39 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

40 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

41 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

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43 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

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45 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

46 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

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