Organ Tranplantation

procedures of Operation 1. To select access route and location . 2. 　☆ To separate the blood vessel which will be used to anastomose. 　 ☆ To remove the diseased organ if orthotopic transplantation will be performed. 3. To transplant graft to proper location. 4. To anastomose the blood vessels of graft and recipient. 5. To anastomose other ducts such as common bile duct and ureter and so on.

Postoperation management 1. The general observation and nursing of 　 postoperation 2. To observe the function of graft 3. Supporting treatment 4. To prevent infection 5. Immunosuppression treatment

Rejection 1. hyperacute rejection ★ 2. accelerated acute rejection ★ 3.  acute rejection ★ 4.  chronic rejection ★

Liver transplantation Indication of liver transplantation 1. Hepatic parenchymal diseases Post hepatitis cirrhosis Alcoholic cirrhosis Fulminant liver failure Multiple cysts of liver 2. Congentital metabolic diseases (inborn error of metabolism)

Tyrosinemia （酪氨酸血症）

Liver transplantation Indication of liver transplantation Faimilial non-hemolytic jaundice ( 家族性非溶血性黄 疸 ) Ghycogenosis ( 糖累积综合征 ) Hepatolenticullar degeneration (wilson’s disease) （肝豆状核变 性） 3 Cholestatic diseases Congentitial atresia of biliary trait （先天性胆 道闭锁） Primary biliary cirrhosis 原发性胆汁性肝硬化 Sclerosing cholengitis

Liver transplantation Indication of liver transplantation 4. Liver Tumor Benign multiple liver adenomatosis 多 发性肝囊腺瘤 Giant hepatic hemangioma 巨大肝血管 瘤 Cholengicarcinoma of liver 肝管细胞癌

Liver transplantation

Harvest of liver graft

Resection and harvest of liver ★ ★

From Brain-death donor From nonheart-beating donor ★ From living-related donor: right lobe,left lobe and left lateral lobe of liver

liver transplantation  Classification of liver transplantation

1 Othotopic liver transplantation ★ Classical or traditional liver transplantation ★ New methods of orthotopic transplantation 　⑴ Reduced-size liver transplantation 　　⑵ living related liver transplantation 　　⑶ Splitting liver transplantation 　　④ Pippy back liver transplantation 2.Heterotopic liver transplantation

Indication of renal transplantation Irreversible renal function failure caused by renal diseases 1. Glomerulonephritis( 肾小球肾炎 ) 2. Chronic pyelonephritis （慢性肾盂肾炎） 3. Genetic diseases such as congentital polycystic kidney （先天性多囊肾） 4. Diabetic nephropathy （糖尿病肾病） 5. Toxicosic diseases such as heavy-metal toxicosis （重 金属中毒） 6. Acute progressive irreversible renal function failure acute tubular necrosis (ATN) 7. Other renal disease: renal trauma and renal tumor

Kidney transplantation Harvest of donor kidney

From living-related donor. From brain-death donor . From nonheart-beating donor . Procedures of renal transplantation Orthotopic renal transplantation : in renal fossa Heterotopic renal transplantation : in iliac fossa

Indication of pancreas and pancreas-kidney transplantations  1.

pancreas transplantation Insulin-dependent diabetes(type I ) to has complication or to be appearing complication  2. pancreas-kidney transplantation  Type I diabetes with renal failure  Type II diabetes with renal failure needing insulin treatment

Procedures of pancreas and pancreas-kidney transplantation 1. Site of transplant ★ to put pancreas in right iliac fossa 　　　 ★ to put kidney in left iliac fossa 2. Reconstruction of blood vessels 3. Management of donor pancreatic excorine secretions ★ pancreatic duct obstruction ★bladder drainge ★ jejunum drainge 4. Management of ureter ★anastomosis of donor’s ureter and recipient’s bladder

Heart transplantation  Indication

Irreversible end stage cardiac dieases. Operation  Orthotopic heart transplantation  Heterotopic heart. transplantation 

Indication and operation of lung-transplantation Indication 1. End-stage pulmonary fibrosis 2. Idiopathic pulmonary fibrosis( 原发性肺纤维 化) 3 ． Chronic obstructive non-infective pulmonary diseases. Paeumonectasis( 肺气肿 ) 4 ． Pulmonary hypertension 5. Chronic and infective pulmonary diseases: bronchiectasis( 支扩 )

Operation of the lung transplantation 1. operation of unilateral lung transplantation

2. operation of bilateral lung transplantation. 3. lung-heart transplantation

Other organs and cells transplantation     

 

1. intestine transplantation 2. spleen transplantation. 3. parathyroid transplantation 4. adrenal gland transplantation 5. testis transplantation 6. ovary transplantation 7. pancreatic islet transplantation 8. bone marrow transplantation

The end