1 / 34

PD, Catheter Exit Site Options

PD, Catheter Exit Site Options. PD catheters : lap vs open. Pre-sternal PD catheter. Chronic Perm Cath Patients Possible Solutions. Second Surgical Opinion Imaging Unusual Access Procedures: Fem Grafts, Necklace Grafts PD HeRO catheters. HeRO cath-graft right central vein occlusion.

candide-workman
Télécharger la présentation

PD, Catheter Exit Site Options

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. PD, Catheter Exit Site Options

  2. PD catheters : lap vs open

  3. Pre-sternal PD catheter

  4. Chronic Perm Cath PatientsPossible Solutions • Second Surgical Opinion • Imaging • Unusual Access Procedures: Fem Grafts, Necklace Grafts • PD • HeRO catheters

  5. HeRO cath-graft right central vein occlusion

  6. Kidney Transplantation Not for everyone !

  7. Transplantation versus Dialysis • Treatment option and not a cure • Quality of Life • time constraints of dialysis • return to work • Life Expectancy • Cost • dialysis cost remains constant • transplantation cost reduces after first year to 1/3 cost of dialysis

  8. Notable Breakthroughs • Immunosuppressant Drugs • Tissue typing • Organ recovery & preservation • Surgical techniques • Non-traditional donor sources

  9. Post Transplant Success UNOS, 2009

  10. Transplant Team Members • Transplant Coordinator • Nephrologist • Transplant Nurse Practitioner/ Physician Assistant • Surgeon • Social Worker • Dietician • Financial Coordinator • Psychologist

  11. Evaluation Overview • Meet all team members • Review medical and social history • Answer questions • Determine plan for further testing • Health screening • Cardiac, Pulmonary, Urologic, Anatomic • Consent Forms

  12. Your Responsibilities • Be active in your evaluation • Keep all of your appointments • Recommend stop smoking • Limit alcohol intake • No illegal drug use • Ask questions

  13. Compatibility Testing • Step #1 ABO Testing • Determination of blood type • Require blood typing on two separate blood draws • ABO Compatibility Recipient Blood Type Donor Blood Type O O A O, A B O, B AB O, A, B, AB

  14. Matching Donors & Recipients • ABO group • HLA (Human Leukocyte Antigen) • Proteins located on surface of white blood cells • Inherited from parents. • PRA (Panel Reactive Antibody) • Measurement of anti-HLA antibodies • Crossmatch • Donor lymphocytes mixed with recipient serum

  15. Sources of Antibodies Previous transplant Blood transfusions Pregnancies Viruses Vaccinations Unknown factors Approximately 30% of patients on the kidney transplant list are sensitized

  16. Benefits of Living Donation • Avoid long waiting time of 3-5 years • Avoid or Limit time on dialysis • Kidney usually works right away • Kidney works longer • Less recovery time in hospital • Transplant can be scheduled at a convenient time

  17. What if my Donor is not a Match? • Paired Kidney Exchange • When donor and recipient are incompatible • Incompatible blood type • Positive Crossmatch • Uses a computer optimization program to match incompatible pairs

  18. Immunosuppression • Medicines to prevent rejection of new organ • Medicines are taken every day • These medicines are needed for the rest of your life! • Side effect of increased risk of infection and cancer

  19. Immunosuppression • Triple Regime • Prednisone • Cellcept/ Mycophenolate Mofetil • Prograf/ Tacrolimus

  20. Making the Choice • Complicated process • Make sure that transplant is right for you • Weigh the risks and benefits • Another form of kidney therapy, not a cure

More Related