Organ-Transplantation-器官移植PPT文件格式下载.ppt
- 文档编号:13881228
- 上传时间:2022-10-14
- 格式:PPT
- 页数:85
- 大小:295.50KB
Organ-Transplantation-器官移植PPT文件格式下载.ppt
《Organ-Transplantation-器官移植PPT文件格式下载.ppt》由会员分享,可在线阅读,更多相关《Organ-Transplantation-器官移植PPT文件格式下载.ppt(85页珍藏版)》请在冰豆网上搜索。
1,OrganTransplantation,JunOuyang,MD,PhDtheFirstAffiliatedHospitalofSoochowUniversity,2,OrganTransplantation(Tx)wasoneofthemostoutstandingmedicalachievementsofthe20thcentury.Asthedevelopmentinthefieldofsurgicaltechniques,immunotherapyresearchandnewimmunosuppressives,OrganTxhasbecomeaeffectivemethodtohealtheendstageorganfailurepatients.,3,Upto2008,over121,000organTxintheworldKidneyTx112745,longestsurvival45ysLiverTx20178,ls31ysHeartTx87543,ls28ysLungTx18576,ls19ysP-kTx16041ls26ys,4,therelationshipbetweentransplantsurgeon,nephrologistsandimmunologistshasservedasamodelformultidisciplinaryteamcare.KidneyTxisthepioneerdisciplineinsolidorganTx.KidneyTxcantrulyrestorepatientswithend-stagerenaldisease.,5,KidneyTx,6,Histroy,1936,S-UVoronoyarmKTx1953,FranceHamburgerliving-relative-donorKTx。
@#@1954,US,twinsKTX.1959-1962,understandingtheroleofimmunotherapy,(Aza)Middle60s,crossmatchingbetweendonor-recipient.,7,KtxinChina,1962,firstcadaverdonorKTx(Dr.Wu)Upto2008,over70,000,ls28ys,8,KTxinourhospital,1976-1977animalexperimental(dog,pig)1978firstcadaverdonorKTxLs26ys2005,livingdonorKTx,9,End-StageRenalDisease(ESRD),IncidenceandPrevalence:
@#@startingrenalreplacementtherapyeachyearforESRDisabout300permilliononpopulation.ThemedianageofthesenewESRDpatientsis65years.BoththeprevalenceandtheincidenceofESRDaremorecommoninelderlythaninyoungpatients,inmenthaninwomen.,10,FrequentcauseofESRD,InChina,themostcommoncauseisglomerulonephritis,followedinorderbydiabetes,hypertension.InUSA,diabetesisespeciallycommonamongnativeAmericansandhypertensionishighamongAfricanAmericans.,11,TreatmentOptionsforESRD,Thetreatmentsthatarechosenforanindividualpatientarethosethatwillallowthelongestextensionofusefullife.RenalreplacementtherapyincludesrenalTxandmaintenancedialysis.RenalTxisthepreferredmethodoftherapyformostpatientswithESRDbecauseitismorecosteffectiveandallowsareturntoamorenormallifestylethanmaintenancedialysisdoes.,12,BarriersoforganTx,SourcesofDonorGraftRejectionOperativetechniques,13,SourcesofDonorKidneys,Livingnonrelateddonors(hb/non-hb)Livingrelateddonors(heartbeating)Cadaverdonors(non-heartbeating),14,Livingdonorsvscadaverdonors,ResultsbetterLessrejectionsLegalbenefitsLongersurvivaltime,15,ThedonormustbeABO-compatiblewiththerecipient.Livingdonorsshouldbeingoodhealthbothphysicallyandpsychologically.Aboveall,thelivingdonorshouldbeavolunteerandmustclearlyunderstandthenatureoftheproceduresothatinformedconsenttotheoperationcanbegiven.Donorsmustbeoflegalage.,16,LivingDonors,Overthelastdecade,morethan10,000peoplehavedonatedkidneysforTx.Themainrisktoadonoristheanesthesiaandtheoperationitself.Themostcommoncomplicationfollowingnephrectomy-exceptforminoratelectasis-iswoundinfection,whichoccursinlessthan1%ofcasesandisusuallysuperficial.,17,Onthebasisofthepreoperativeevaluation,Drsmustbeabletoassurethelivingdonorofnearlynormalrenalfunctionafterunilateralnephrectomy.Onevaluation,ifoneofthepotentialdonorskidneysisbetterthantheother,thebetterkidneyisleftwiththedonor,18,Cadaverdonors,Sinceonly30%ofrecipientshaveasuitablelivingdonor,theonlywaytoprovideTxtomostpatientsistousecadaverkidneys.Itisessentialtothesuccessoftheprocedurethatthetransplantedorganbeofgoodquality.Itisalsoimportantthatthedonorhaverelativelynormalrenalfunctionatthetimeofdeath.Phenoxybenzamineoranothervasodilatordrugisoftengiventopreventrenalvasospasmduringtheagonalphase.,19,Thecriteriaforanidealcadaverkidneydonorarenormalrenalfunction,nohypertensionrequiringtreatment,nodiabetesmellitus,nomalignancyotherthanaprimarybraintumorortreatedsuperficialskincancer,nogeneralizedviralorbacterialinfection,acceptableurinalysis,agebetween6and45years,andnegativeassaysforsyphilis,hepatitis,HIV,andhumanT-lymphoproliferativevirus.,20,SelectionofRecipients,Theidealrecipientisonewhohasnoseriousinfectionsorlowerurinarytractdisease,withminimalandreversiblesystemicdiseasesecondarytorenalfailure.Recipientswiththefollowingprimaryrenaldiseaseshavebeensuccessfullytransplanted:
@#@glomerulonephritis,pyelonephritis,polycystickidneydisease,malignanthypertension,refluxpyelonephtis,Goodpasturessyndrome,congenitalrenalhypoplasia,renalcorticalnecrosis,FabryssyndromeandAlportssyndrome.,21,Successfultransplantshavebeenachievedinpatientswithcertainsystemicdiseasesinwhichthekidneyisoneoftheendorgans(cystinosis,systemiclupuserythematosusandtype1diabetes).RenalTxisgenerallycontraindicatedinoxalosisbecausethediseaserecur
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- Organ Transplantation 器官移植
![提示](https://static.bdocx.com/images/bang_tan.gif)