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Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

14
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
14
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

20
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

22
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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Related Experiment Video

Updated: Jul 11, 2025

Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
06:55

Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP

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Optimizing the prelung transplant candidate.

John Pagteilan1, Scott Atay

  • 1Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.

Current Opinion in Organ Transplantation
|November 7, 2023
PubMed
Summary

Optimizing lung transplant candidates involves early intervention for frailty and gastroesophageal reflux disease (GERD). Strategies like rehabilitation and surgical correction improve graft function and long-term outcomes.

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Last Updated: Jul 11, 2025

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Area of Science:

  • Pulmonary Medicine
  • Transplant Surgery
  • Critical Care Medicine

Background:

  • Lung transplant outcomes are significantly influenced by modifiable risk factors, with candidate deterioration during the waitlist period posing a persistent challenge.
  • Recent advancements in technology and management strategies aim to identify and mitigate pretransplant morbidity, thereby enhancing both short- and long-term transplant success.

Approach:

  • This review focuses on recent innovations in pretransplant recipient assessment and optimization strategies.
  • Key areas include the development of lung transplant-specific frailty assessments and the evaluation of early surgical interventions for gastroesophageal reflux disease (GERD).
  • The role of extracorporeal life support as a bridge to transplant is also examined in light of new evidence.

Key Points:

  • Pretransplant frailty, identified through specific assessments, can be positively impacted by rehabilitation and is reversible post-transplant, influencing candidate selection.
  • Early surgical correction of GERD, particularly partial fundoplication for esophageal dysmotility, improves graft function and longevity compared to medical management alone.
  • Extracorporeal membrane oxygenation (ECMO) is an appropriate invasive support to maintain strength and mobility, with awake, ambulatory ECMO being preferred.

Conclusions:

  • Early intervention and optimization of pretransplant risk factors are crucial for improving lung transplant outcomes.
  • Comprehensive candidate assessment, including frailty evaluation and management of conditions like GERD, is essential for successful transplantation.
  • Innovative approaches, including advanced life support and surgical techniques, are transforming pretransplant care and patient selection.