pd, catheter exit site options. pd catheters : lap vs open
TRANSCRIPT
![Page 1: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/1.jpg)
PD, Catheter Exit Site PD, Catheter Exit Site OptionsOptions
![Page 2: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/2.jpg)
![Page 3: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/3.jpg)
PD catheters : lap vs PD catheters : lap vs openopen
![Page 4: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/4.jpg)
![Page 5: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/5.jpg)
Pre-sternal PD catheterPre-sternal PD catheter
![Page 6: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/6.jpg)
![Page 7: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/7.jpg)
Chronic Perm Cath PatientsChronic Perm Cath PatientsPossible SolutionsPossible Solutions
Second Surgical OpinionSecond Surgical Opinion
ImagingImaging
Unusual Access Procedures: Fem Grafts, Unusual Access Procedures: Fem Grafts, Necklace GraftsNecklace Grafts
PDPD
HeRO cathetersHeRO catheters
![Page 8: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/8.jpg)
HeRO cath-graft HeRO cath-graft right central vein occlusionright central vein occlusion
![Page 9: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/9.jpg)
Kidney Kidney TransplantationTransplantation
Not for everyone !Not for everyone !
![Page 10: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/10.jpg)
Transplantation versus Transplantation versus DialysisDialysis
Treatment option and not a cureTreatment option and not a cure Quality of LifeQuality of Life
time constraints of dialysistime constraints of dialysis return to workreturn to work
Life ExpectancyLife Expectancy CostCost
dialysis cost remains constantdialysis cost remains constant transplantation cost reduces after first year transplantation cost reduces after first year
to 1/3 cost of dialysisto 1/3 cost of dialysis
![Page 11: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/11.jpg)
Notable BreakthroughsNotable Breakthroughs Immunosuppressant DrugsImmunosuppressant Drugs Tissue typingTissue typing Organ recovery & preservationOrgan recovery & preservation Surgical techniquesSurgical techniques Non-traditional donor sourcesNon-traditional donor sources
![Page 12: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/12.jpg)
![Page 13: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/13.jpg)
Post Transplant SuccessPost Transplant Success
Deceased Donor Kidney Recipients
Live Donor Kidney Recipients
1 Year 94.5% 97.9%
5 Year 81.8% 90.5%
UNOS, 2009
![Page 14: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/14.jpg)
Transplant Team Transplant Team MembersMembers
Transplant CoordinatorTransplant Coordinator NephrologistNephrologist Transplant Nurse Practitioner/ Physician Transplant Nurse Practitioner/ Physician
AssistantAssistant SurgeonSurgeon Social WorkerSocial Worker DieticianDietician Financial CoordinatorFinancial Coordinator PsychologistPsychologist
![Page 15: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/15.jpg)
Evaluation OverviewEvaluation Overview
Meet all team membersMeet all team members Review medical and social historyReview medical and social history Answer questionsAnswer questions Determine plan for further testingDetermine plan for further testing
Health screeningHealth screening Cardiac, Pulmonary, Urologic, AnatomicCardiac, Pulmonary, Urologic, Anatomic
Consent FormsConsent Forms
![Page 16: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/16.jpg)
Your ResponsibilitiesYour Responsibilities
Be active in your evaluationBe active in your evaluation Keep all of your appointmentsKeep all of your appointments Recommend stop smokingRecommend stop smoking Limit alcohol intakeLimit alcohol intake No illegal drug useNo illegal drug use Ask questionsAsk questions
![Page 17: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/17.jpg)
Compatibility Testing
Step #1 ABO Testing Determination of blood type Require blood typing on two separate blood draws
ABO CompatibilityRecipient Blood Type Donor Blood Type
O OA O, AB O, BAB O, A, B, AB
![Page 18: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/18.jpg)
Matching Donors & Matching Donors & RecipientsRecipients
ABO groupABO group HLA (Human Leukocyte HLA (Human Leukocyte
Antigen)Antigen) Proteins located on surface Proteins located on surface
of white blood cellsof white blood cells Inherited from parents.Inherited from parents.
PRA (Panel Reactive Antibody)PRA (Panel Reactive Antibody) Measurement of anti-HLA Measurement of anti-HLA
antibodiesantibodies CrossmatchCrossmatch
Donor lymphocytes mixed Donor lymphocytes mixed with recipient serumwith recipient serum
![Page 19: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/19.jpg)
Sources of AntibodiesSources of Antibodies
Previous transplant Previous transplant Blood transfusionsBlood transfusions PregnanciesPregnancies VirusesViruses VaccinationsVaccinations Unknown factorsUnknown factors Approximately 30% of patients on Approximately 30% of patients on
the kidney transplant list are the kidney transplant list are sensitizedsensitized
![Page 20: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/20.jpg)
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
![Page 21: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/21.jpg)
Paired Kidney ExchangePaired Kidney Exchange When donor and recipient are When donor and recipient are
incompatibleincompatible Incompatible blood typeIncompatible blood type Positive CrossmatchPositive Crossmatch
Uses a computer optimization Uses a computer optimization program to match incompatible pairsprogram to match incompatible pairs
What if my Donor is not What if my Donor is not a Match?a Match?
![Page 22: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/22.jpg)
![Page 23: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/23.jpg)
![Page 24: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/24.jpg)
![Page 25: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/25.jpg)
![Page 26: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/26.jpg)
![Page 27: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/27.jpg)
![Page 28: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/28.jpg)
![Page 29: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/29.jpg)
ImmunosuppressionImmunosuppression
Medicines to prevent rejection of Medicines to prevent rejection of new organnew organ
Medicines are taken every day Medicines are taken every day These medicines are needed for the These medicines are needed for the
rest of your life!rest of your life! Side effect of increased risk of Side effect of increased risk of
infection and cancerinfection and cancer
![Page 30: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/30.jpg)
![Page 31: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/31.jpg)
ImmunosuppressionImmunosuppression
Triple RegimeTriple Regime PrednisonePrednisone Cellcept/ Mycophenolate MofetilCellcept/ Mycophenolate Mofetil Prograf/ TacrolimusPrograf/ Tacrolimus
![Page 32: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/32.jpg)
![Page 33: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/33.jpg)
Making the ChoiceMaking the Choice
Complicated processComplicated process Make sure that transplant is right Make sure that transplant is right
for youfor you Weigh the risks and benefitsWeigh the risks and benefits Another form of kidney therapy, not Another form of kidney therapy, not
a curea cure
![Page 34: PD, Catheter Exit Site Options. PD catheters : lap vs open](https://reader035.vdocuments.site/reader035/viewer/2022062407/56649d975503460f94a81b77/html5/thumbnails/34.jpg)