Physical Therapy in Organ Transplantation PDF
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MTI University
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Summary
This document provides an overview of physical therapy considerations in organ transplantation, focusing specifically on kidney transplantation. It explains the role of physical therapy in managing various aspects of the pre-transplant and post-transplant patient journey. The document details complications and contraindications, offering a comprehensive perspective for healthcare professionals and students.
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Physical Therapy Department for surgery and dermatology –Faculty of Physical Therapy- MTI University Role of physical therapy in Organ transplantation Transplantation Transplantation is done to replace an end-stage diseased organ, thereby restoring an essential function and improving pat...
Physical Therapy Department for surgery and dermatology –Faculty of Physical Therapy- MTI University Role of physical therapy in Organ transplantation Transplantation Transplantation is done to replace an end-stage diseased organ, thereby restoring an essential function and improving patient survival. Regarding to site, tissues may be grafted to: Anatomically Normal site (Orthotopic; eg, heart amd liver transplants). Abnormal site (Heterotopic; eg,kidney transplanted into the iliac fossa). Transplant types The patient’s own tissue (Autografts; eg, bone, bone marrow, and skin grafts) Genetically identical (Syngeneic [between monozygotic twins]) donor tissue (Isografts) Genetically dissimilar donor tissue (Allografts, or Homografts) Rarely, grafts from a different species (Xenografts, or Heterografts) Transplanted tissues Cells (as for hematopoietic stem cell, lymphocyte) Parts or segments of an organ (as for liver or pulmonary lobar transplants and skin grafts) Entire organs (as for heart, liver or kidney transplants) Tissues (corneas) Contraindications Absolute: Active infection Cancer A positive cross-match identified by lymphocytotoxic testing Relative: Age > 65 Poor functional or nutritional status (including severe obesity) HIV infection Multi-organ insufficiency Renal Transplantation Is the organ transplant of a kidney into a patient with end-stage renal disease (only functioning at 10 to 15 percent of their normal capacity). Chronic kidney disease is kidney damage that occurs slowly over many years, often due to diabetes or high blood pressure. Kidney transplantation is typically classified as: Cadaveric or Living-donor transplantation depending on the source of the donor organ. Contraindication Absolute contraindications Co-morbidities that could compromise graft survival severe heart disorders- cancer Relative contraindications Poorly controlled diabetes, which can lead to rapid failure of the allograft. Renal Transplantation Special Considerations related to chronic kidney disease: As the kidney function decreases Increased serum creatinine & protein in the urine. Blood pressure is increased due to fluid overload and production of vasoactive hormones hypertension and heart failure. Hyperkalemia as Potassium accumulates in the blood malaise and Cardiac arrhythmias. Fluid overload due to water retention and decreased serum albumin mild edema ~ life-threatening pulmonary edema. Renal Transplantation Changes in mineral and bone metabolism : 1) abnormalities of, increased phosphorus (phosphate)(>0.8- 1.4 mmol/l), increased parathyroid hormone, Lower levels of calcium (