Transplantation at a Glance E-Book

Menna Clatworthy

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: At a Glance
• Sprache: Englisch

Seitenzahl: 226

Veröffentlichungsjahr: 2012

Beschreibung

The first basic overview of all aspects of transplantation with a clarity not to be found in more inaccessible textbooks. 

This brand new title provides a succinct overview of both the scientific and clinical principles of organ transplantation and the types of organ transplant, featuring highly-illustrated information covering core topics in transplantation including:

• Organ donors
• Organ preservation
• Assessment of transplant recipients
• Indications for transplantation
• Immunology of transplantation
• Immunosuppression and its complications
• Overviews of thoracic and abdominal organ transplantation, including the kidneys, liver, heart and lungs

Transplantation at a Glance is the ideal introduction for medical students, junior doctors, surgical trainees, immunology students, pharmacists, and nurses on transplant wards.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Preface

List of abbreviations

1 History of transplantation

Fundamentals

Early transplants

Development of immunosuppression

Non-renal organ transplants

Organ donors

2 Diagnosis of death and its physiology

Diagnosing death

Causes of death

Physiology of brainstem death

3 Deceased organ donation

Opting in or opting out?

Patterns of organ donation

Organ retrieval

Contraindications to donation

Suboptimal organs

4 Live donor kidney transplantation

Living kidney donation

5 Live donor liver transplantation

Live liver donation

Live donor liver surgery

Live liver donor assessment

Risks of donation

Organ preservation

6 Organ preservation

The effects of ischaemia

Principles of organ preservation

Static storage or machine perfusion

Immunology of organ transplantation

7 Innate immunity

The complement system

Pentraxins

Phagocytes

Mast cells

Natural killer cells

8 Adaptive immunity and antigen presentation

The adaptive immune system

Antigen presentation in transplantation

9 Humoral and cellular immunity

Humoral (antibody-mediated) immunity

Cellular immunity

Regulatory immune cells

Histocompatibility in transplantation

10 Tissue typing and HLA matching

ABO antigens

HLA antigens

HLA nomenclature

HLA matching

11 Detecting HLA antibodies

Screening prior to transplantation

Screening at the time of transplantation

Transplantation without a cross-match

12 Antibody-incompatible transplantation

Antibody specificity

Desensitisation procedure

Paired exchange kidney donation

Organ allocation

13 Organ allocation

Eligibility for transplantation

Principles in organ allocation

Allocation in practice

Immunosuppression

14 Immunosuppression: induction vs maintenance

15 Biological agents

16 T cell-targeted immunosuppression

Complications of immunosuppression

17 Side effects of immunosuppressive agents

Corticosteroids

Calcineurin inhibitors (CNIs)

Anti-metabolites

mTOR inhibitors

Biological agents

18 Post-transplant infection

19 CMV infection

Risk of CMV infection post transplant

Clinical features of CMV infection

Diagnosis

Treatment

Complications of CMV infection

20 Post-transplant malignancy

Incidence of malignancy

Risk factors

Types of cancer

Kidney transplantation

21 End-stage renal failure

Classification of renal failure

Diseases that recur in the transplant

22 Complications of ESRF

Failure of renal excretory functions

Failure of renal synthetic functions

Morbidity and mortality of patients with CKD/ESRF

23 Dialysis and its complications

Haemodialysis complications

Peritoneal dialysis complications

Mortality on dialysis

24 Assessment for kidney transplantion

25 Kidney transplantation: the operation

The donor kidney

Implantation

Transplant outcomes

26 Surgical complications of kidney transplantation

Vascular complications

Ureteric complications

Wound complications

27 Delayed graft function

Causes of DGF

Prevalence of DGF

Risk factors for post-transplant DGF

Diagnosis of post-transplant ATN

Management of post-transplant ATN

Clinical course of post-transplant ATN

28 Transplant rejection

Hyperacute rejection

Acute cellular rejection

Acute antibody-mediated rejection

29 Chronic renal allograft dysfunction

Non-immunological chronic allograft dysfunction

Immunological chronic allograft dysfunction

Pancreas and islet transplantation

30 Transplantation for diabetes mellitus

Diabetes mellitus

Indications

31 Pancreas transplantation

Categories of transplant

Patient assessment

Transplantation

Immunosuppression and prophylaxis

Complications

Long-term outcomes

32 Islet transplantation

Indications for islet transplantation

Assessment for transplantation

Islet isolation and transplantation

Complications

Pancreas or islets?

Liver transplantation

33 Causes of liver failure

Causes of liver failure

34 Assessment for liver transplantation

Assessment of the transplant candidate

35 Liver transplantation: the operation

Recipient hepatectomy

Implantation of the new liver

36 Complications of liver transplantation

Monitoring the liver

Surgical complications

Medical complications

Long-term outcomes

Intestinal transplantation

37 Intestinal failure and assessment

Intestinal failure

Indications for transplantation

Assessment for transplantation

Results of intestinal transplantation

38 Intestinal transplantation

Types of transplant

Donor assessment

Operative issues

Post-transplant complications

Heart transplantation

39 Assessment for heart transplantation

Assessment for transplantation

Bridge to transplantation

40 Heart transplantation: the operation

Donor selection

Transplanting the heart

41 Complications of heart transplantation

Early complications

Immunosuppression

Rejection

Outcomes of heart transplantation

Lung transplantation

42 Assessment for lung transplantation

Indications for lung transplantation

Priority for transplantation

Contraindications to transplantation

43 Lung transplantation: the operation

The lung donor

Lung transplantation

44 Complications of lung transplantation

Early complications

Late complications

Composite tissue transplantation

45 Composite tissue transplantation

Hand transplantation

Face transplantation

Immunosuppression and rejection

Xenotransplantation

46 Xenotransplantation

Aspirations for xenotransplantation

Barriers to success

Index

This edition first published 2012 © 2012 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Transplantation at a glance / Menna Clatworthy . . . [et al.].

p. ; cm. – (At a glance)

 Includes bibliographical references and index.

 ISBN 978-0-470-65842-0 (pbk. : alk. paper)

 I. Clatworthy, Menna. II. Series: At a glance series (Oxford, England).

 [DNLM: 1. Organ Transplantation. 2. Transplantation Immunology. 3. Transplants. WO 660]

 617.9'54–dc23

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: Science Photo Library

Preface

The early attempts at transplantation in the first half of the 20th century were limited by technical challenges and ignorance of the immune response. Half a century later, with an appreciation of some aspects of human immunology, the first successful renal transplant was performed between identical twins. From these beginnings transplantation has progressed from being an experimental treatment available to a few, to a thriving discipline providing life-changing treatment for many. Its power to dramatically transform the quality and quantity of life continues to capture and inspire those involved at all levels of care. Transplantation is a truly multidisciplinary specialty where input from physicians, surgeons, tissue-typists, nurses, coordinators and many others is required in the provision of optimal care. It is also a rapidly moving discipline in which advances in surgical technique and immunological knowledge are constantly being used to improve outcomes. As a newcomer to the field, the breadth of knowledge required can appear bewildering, and it is with this in mind that we have written Transplantation at a Glance. We hope that in this short, illustrated text we have provided the reader with a succinct, yet comprehensive overview of the most important aspects of transplantation. The book is designed to be easily read and to rapidly illuminate this exciting subject. We have long felt that many aspects of transplantation are best conveyed by diagrammatic or pictorial representation, and it was this conviction that led to the creation of Transplantation at a Glance. In particular, the two fundamentals of transplantation, basic immunology and surgical technique, are best learned through pictures. For those approaching transplantation without a significant background in immunology or the manifestations of organ failure, we have provided an up-to-date, crash course that allows the understanding of concepts important in transplantation so that subsequent chapters can be easily mastered. For those without a surgical background, the essential operative principles are simply summarised. Most importantly, throughout the text we have aimed to provide a practical and clinically relevant guide to transplantation which we hope will assist those wishing to rapidly familiarise themselves with the field, regardless of background knowledge.

MRCCJEW

List of Abbreviations

6-MP

6-mercaptopurine

ACR

acute cellular rejection; albumin–creatinine ratio

ADCC

antibody-dependent cellular cytotoxicity

ADH

antidiuretic hormone

AKI

acute kidney injury

ALD

alcohol-related liver disease

ALG

anti-lymphocyte globulin

ALP

alkaline phosphatase

ALT

alanine transaminase

AMR

antibody-mediated rejection

ANCA

antineutrophil cytoplasmic antibody

APC

antigen-presenting cell

APD

automated peritoneal dialysis

APKD

adult polycystic kidney disease