Your SlideShare is downloading. ×
0
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Primary non functioning graft
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Primary non functioning graft

493

Published on

Primary non function of a transplant is the most catastrophic outcome in kidney transplantation.

Primary non function of a transplant is the most catastrophic outcome in kidney transplantation.

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
493
On Slideshare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Mr. Adil El Tayar FRCS, FEuBTS Consultant Transplant Surgeon Ibn Sina Hospital
  • 2. Transplantation Transplantation is the transfer (engraftment) of human cells, tissues or organs from a donor to a recipient with the aim of restoring function(s) in the body
  • 3. Types of grafts  Auto graft No immunogenic barrier.  Isograft Genetically identical monozygotic twins and inbred strains.  Allograft Genetically non identical individuals  Xenograft Across species barrier
  • 4. GRAFT Function PNF means total and irreversible loss of function after transplantation. P dysfunction G means irreversible but partial impairment of function DGF means the organ fails to function at first but start to function later.
  • 5. Alex Carrel in 1901  Alex Carrel in 1901 wrote “I have started research into the procedure of vascular anastomosis in order to be able to transplant certain organs.....”
  • 6. Alex Carrel technique  He defined the two factors essential to the success of this anastomosis:  a meticulous surgical technique  protection against the risk of infection.
  • 7. First hand transplant: by Professor Jean-Michel Dubernard in Lyon. In 1998
  • 8. They made the mistake of picking the wrong patient.
  • 9. Mrs. Renard and her son Marius
  • 10. Causes of PNF      1. 2. 3.   1. 2. 3.   Xenotransplantation ABO incompatibility Sensitized patients Non heart beating kidney donation Ischemia time Warm Ischemia Cold Ischemia Re-warm Ischemia Perfusion fluid Surgical complications Renal artery thrombosis Venous thrombosis Urological obstruction Drugs Toxicity Recurrent of primary disease
  • 11. Xenotransplantation  Transplantation across species barrier  Discordant when there is a preformed anti bodies similar to Blood grouping ( pig to man)  Concordant when there is no preformed antibodies ( baboon to man)
  • 12. Mathieu Jaboulay 1906  First Xenotransplantation ( Left kidney from a pig into the cubital fossa of woman with nephrotic syndrome)
  • 13. Hyper acute Rejection  Xenotransplantation  ABO incompatible  Pre formed Anti HLA antibodies
  • 14. Cortical necrosis a histopathological feature of severe vascular rejection
  • 15. C4d positive immunohistological marker of humoral rejection
  • 16. Avoid Hyper acute rejection  Blood group compatible  Initial cross match  Final cross match  DSA  Desensitization CDC test Flow cytometry
  • 17. Yu Yu Voronoy 1933  The first human kidney allograft, carried out in Kiev in 1933 using the thigh location
  • 18. Non-heart beating kidney donation  Categories of non heart beating donors: 1. Dead on arrival 2. Unsuccessful resuscitation 3. Awaiting cardiac arrest. 4. Cardiac arrest during or after brain stem diagnosis
  • 19. Strategies of Organ Preservation  To maintain survival capacity over the necessary time and to ensure rapid resumption of function after transplantation: 1. Simulate as exactly as possible the physiological environment of the organ during the extracorporeal phase. 2. Use of hypothermia and pharmacological inhibition to slow down metabolic process in the ischemic /anoxic organ
  • 20. Renal vein thrombosis
  • 21. Transplant Clinical and Business Multidisciplinary Team Transplant Surgeon Public Relatio Information n Technology Transplant Anaesthesia Transplant Physician Transplant Administration Patient Registration Financial Coordination OPO Relatio n Transplant Patient Transplant Coordinator Transplant Sister Social Worker Ward Manager Impatient Unit Cost Reporting Transplant Dietation Data Management Transplant Pharmacist Routine Laboratory HLA Laboratory

×