1954- First kidney transplant performed from one identical twin to the other.

Transplant success is closely tied to obtaining an organ with tissue antigens as close to those of the recipient as possible. every body cell has cell surface antigens known as the Human Leukocyte Antigens (HLA) that are unique to each individual. Matching the HLA type of the donor and recipient as closely as possible decreases the potential for rejection of the transplanted organ or tissue.

Types of Tissue Graft

Autograft
Isograft Allograft

Xenograft

HEART
L U N G S

BONE MARROW

SKIN

CORNEA

PANCR EAS

Host versus-Graft Disease (HVGD)

Graft-versus-Host Disease ( GVHD)

HVGD - Hyperacute Rejection cyanotic, mottled appearance of the organ - Acute Rejection fever, redness, swelling, tenderness of the graft site -Chronic Tissue Rejection organ failure, fibrosis of the organ

GVHD maculopapular pruritic rash, desquamation, abdml pain, nausea, bloody diarrhea, jaundice, abnormal liver function tests

HYPERACUTE

ACUTE CHRONIC

Diagnostic Test
Blood type and Rh factor Crossmatching HLA histocompatibility Mixed lymphocyte culture Assay test Ultrasonography or MRI Tissue biopsies

Medications
Trimethroprim-sulfamethaxazole Acyclovir Ganciclovir Corticosteroids and cyclosporine Azathioprine Mycophenolate mofetil OKT3 or Muromonab- CD3

Nursing Diagnosis and

Management Ineffective Protection

Altered protection is a problem for transplant clients at all stages. Before transplant occurs, failure of affected organ may put the client at risk for infection.

 Wash hands on entering the room and before providing direst care. Assess frequently for signs and symptoms of infection and monitor the temperature and vital signs q4h Monitor lab values including CBC and tests for organ function Report changes to the physician Initiate reverse or protective isolation procedure as indicate by the clients immune status Help ensure adequate nutrient intake offering supplementary feedings as indicated or maintaining parenteral nutrition as necessary Change IV bags and tubing at least every 24 hrs and change peripheral IV site every 48-72 hrs unless indicated Provide mouth care