the degree and speed at which a drug enters the bloodstream from the small intestine
ACUTE TUBULAR NECROSIS (ATN)
reversible kidney damage resulting in delayed kidney function. Among other factors, it may be caused by quality of donor organ, time of organ storage before transplantation, or medications to prevent rejection.
ALKALINE PHOSPHATASE
an enzyme produced by liver (and other) cells; elevated blood levels of this substance may indicate abnormal function of the liver or other organs
ANEMIC
low red blood cell count
ANESTHETIC
medication that reduces pain by dulling sensation
ANTACID
a drug that aids in protecting the digestive system and relieves heartburn and digestive discomfort
ANTIBODY
a protein produced by the body to eliminate foreign substances, such as bacteria
ANTIGEN
a foreign molecule or substance, such as a transplant, that triggers an immune response. This response may be the production of antibodies, which, in turn, try to inactivate or destroy the antigen (transplanted organ)
ARTERIOGRAM (angiogram)
an x-ray of the arteries taken with the aid of a dye
ATHEROSCLEROSIS
a buildup of fats in the lining of the arteries that may interfere with the flow of blood
B Cell
a specialized white blood cell responsible for the body's immunity. B cells play a central role in antibody production
BACTERIA
small organisms (germs) that can cause disease
BIOAVAILABILITY
a measure of how much of an administered drug is absorbed into the bloodstream, actually reaching the intended site of action in the body. For example, medicine is absorbed from the GI tract, travels through the bloodstream, and reaches the organ tissues, where it works to fight infection, prevent rejection, etc.
BIOPSY
the removal and examination of tissue for diagnosis
BLADDER
the part of the urinary tract that receives urine from the kidneys and stores it until urination
BRAIN DEATH
when the brain has permanently stopped working, as determined by a neurological surgeon, artificial support systems may maintain functions such as heartbeat and respiration for a few days
BUN
BUN stands for blood urea nitrogen, a waste product normally excreted by the kidney. Your BUN value represents how well the kidneys function
CADAVERIC DONOR
an individual who has recently died of causes that do not affect the function of an organ to be transplanted. Either the person or the person's family has generously offered organs and/or tissues for transplantation
CELLCEPT®
an immunosuppressive drug used with other immunosuppressants to prevent the rejection of the transplanted organ. Also known by its chemical name, myophenolate mofetil
CHOLESTEROL
a form of fat that performs necessary functions in the body but can also cause heart disease; cholesterol is found in animal foods such as meat, fish, poultry, eggs, and dairy products
CORTICOSTEROIDS
a category of immunosuppressive medications that includes prednisone and prednislone
CREATININE
a substance found in blood and urine; it results from normal body chemical reactions; high blood creatinine levels are a sign of depressed kidney function
CROSSMATCH
a test in which donor and recipient blood samples are mixed together. A "positive" crossmatch shows the donor and recipient are incompatible. A "negative" crossmatch shows there is no reaction between the donor and the recipient. This means that the donor and recipient are compatible and the transplant may proceed.
CYCLOSPORINE
the immunosuppressive ingredient in Neoral® (cyclosporine capsules and oral solution for microemulsion) and Sandimmune® (cyclosporine), an earlier form of cyclosporine. Neoral® and Sandimmune are not bioequivalent and cannot be used interchangeably without physician supervision
CMV (CYTOMEGALOVIRUS)
a virus infection that is very common in transplant recipients; it can affect the lungs and other organs as well; a member of the family of herpes viruses
DETOXIFY
to change a harmful substance into a safer form
DIABETES
a disease in which patients have high levels of sugar in their blood
DIALYSIS
the process of cleansing and achieving chemical balance in the blood of patients whose kidneys have failed. Dialysis may refer to hemodialysis or peritoneal dialysis (PD)
DIASTOLIC
the bottom of two blood pressure numbers, which measures blood pressure when the heart is at rest
EDEMA
excess fluid in body tissues; swelling of the ankles, for example, is a sign of edema
ELECTROCARDIOGRAM
a recording of the electrical activity of the heart
ELECTROLYTE
generally refers to the dissolved form of a mineral such as sodium, potassium, magnesium, chlorine, etc.
ENZYME
a protein made in the body and capable of changing a substance from one form to another
FETUS
a human embryo in the mother's uterus
GASTROENTEROLOGIST
a physician who specializes in the care of the digestive tract
GINGIVAL HYPERTROPHY
enlargement of the gums. It is a common side effect of cyclosporine therapy, but can be managed with good oral hygiene
GLUCOSE
a type of sugar found in the blood
GRAFT
an organ or tissue that is transplanted
GRAFT SURVIVAL
when a transplanted tissue or organ is accepted by the body and functions properly. The potential for graft survival is increased when the recipient and donor are closely matched, and when immunosuppressive therapy is used
HELPER T CELL
the specialized white blood cell that tells other parts of the immune system to combat infection or foreign material
HEMATOCRIT
a measure of the red-blood-cell content of blood
HEMODIALYSIS
a method of dialysis in which blood is purified by circulating through an apparatus outside the body (sometimes called an "artificial kidney")
HERPES
a family of viruses that infect humans; herpes simplex causes lip and genital sores; herpes zoster causes shingles
HIRSUTISM
an excessive increase in hair growth - especially male-pattern hair growth in a female. Hirsutism is a common side effect of corticosteroids and can also occur with cyclosporine therapy, but is easily treated with depilatory creams or other methods of hair removal
HISTOCOMPATIBILITY
the examination of human leukocyte antigens (HLA) in a patient, often referred to as "tissue typing" or "genetic matching". Tissue typing is routinely performed for all donors and recipients in kidney and pancreas transplantation to help match the donor with the most suitable recipients. This helps to decrease the likelihood of "rejecting" the transplanted organ.
HLA (human leukocyte antigens) system
genetically determined series of antigens that are present on human white blood cells (leukocytes) and tissues
HYPERTENSION
high blood pressure
IMMUNE RESPONSE
any defensive reaction to foreign material by the immune system
IMMUNE SYSTEM
the system that protects the body from invasion by foreign substances, such as bacteria and viruses, and from cancer cells
IMMUNITY
a condition of being able to resist a particular infectious disease
IMMUNOSUPPRESSIVE AGENTS
medications given to prevent rejection of a transplanted organ
IMURAN®
an immunosuppressive drug used with other immunosuppressive drugs to help prevent the rejection of a transplanted organ. Also known by its chemical name, azathioprine
INCOMPATIBLE
no likeness or similarity between donor or recipient blood type or organs
IV, or INTRAVENOUS
refers to giving medicines or fluids directly through a vein
IV CATHETER
a small needle with a hollow tube inserted into a vein and used to give medicines or fluids
KIDNEY
one of the two kidney-bean-shaped organs located on both sides of the spine, just above the waist. They rid the body of waste materials and maintain fluid balance through the production of urine
LIVING-RELATED DONOR (LRD)
a blood relative who donates an organ
MATCH
the compatibility between recipient and donor. In general, the more closely the donor and recipient "match", the greater the potential for a successful transplant
MICROEMULSION
a suspension or mixture of tiny droplets of one liquid in a second liquid, such as the smooth mixture that is formed when Neoral® (cyclosporine capsules and oral solution for microemulsion) combines with fluids in the digestive system
NEPHROLOGIST
a physician who studies the kidney and treats kidney disease
NEUTROPHIL
a type of white blood cell
NONCOMPLIANCE
failure to follow the instructions of one's health care providers, such as not taking medicine as prescribed or not showing up for clinic visits
ORGAN PRESERVATION
between organ procurement and transplant, organs require special methods of preservation to keep them viable. The length of time that organs and tissues can be kept outside the body varies, depending on the organ, the preservation fluid and the temperature.
ORGAN PROCUREMENT ORGANIZATION (OPO)
OPO's serve as the integral link between the potential donor and recipient and are accountable for the retrieval, preservation and transportation of organs for transplantation. All OPOs are UNOS members.
ORGAN REJECTION
an attempt by the immune system to reject or destroy what it recognizes to be a "foreign" presence (for example, a transplanted liver)
PANEL REACTIVE ANTIBODY (PRA)
a way of measuring immune system activity within the body. PRA is higher when more antibodies are being made.
PCP
Pneumocystis carinii pneumonia, a type of pneumonia seen primarily in patients whose immune systems are suppressed
PERITONEAL DIALYSIS
a method of purifying the blood by flushing the abdominal cavity with a dilute salt solution
PLATELET
a small blood cell needed for normal blood clotting
POTASSIUM
a mineral essential for body function
PREDNISONE
a manufactured steroid hormone taken by most transplant recipients to help prevent rejections
PROPHYLACTIC MEDICATION
medication that helps prevent disease
RAPAMYCIN (RAPAMUNE®)
Rapamycin belongs to a group of medicines known as immunosuppressive agents. It is used to lower the body's natural immunity in patients who receive kidney transplants. When a patient receives an organ transplant, the body's white blood cells will try to get rid of (reject) the transplanted organ. Rapamycin works by preventing the white blood cells from getting rid of the transplanted organ.
REJECTION
an immune response against grafted tissue, which, if not successfully treated, results in failure of the graft to survive
RETRANSPLANTATION
due to organ rejection or transplant failure, some patients need another transplant and return to the waiting list. Reducing the number of retransplants is critical when examining ways to maximize a limited supply of donor organs.
SANDIMMUNE®
(cyclosporin)
an earlier formulation of cyclosporine. An immunosuppressive drug used with other immunosuppressive drugs, that acts specifically to inhibit helper T cells, thereby helping prevent the rejection of a transplanted organ. Sandimmune and Neoral are not bioequivalent and cannot be used interchangeably without physician supervision
SENSITIZED
being immunized, or able to mount an immune response, against an antigen by previous exposure to that antigen
SHINGLES
a herpes virus infection (herpes zoster) that usually affects a nerve, causing pain in one area of the body
SODIUM
a component of table salt (sodium chloride); an electrolyte that is the main salt in blood
STRICTURE or STENOSIS
a narrowing of passage in the body
SURVIVAL RATES
survival rates indicate how many patients or grafts (transplanted organs) are alive/functioning at a set time posttransplant. Survival rates are often given at one, three and five years. Policy modifications are never made without examining their impact on transplant survival rates. Survival rates improve with technological and scientific advances. Developing policies that reflect and respond to these advances in transplantation will also improve survival rates.
the top of the two blood pressure numbers, which measures the maximum blood pressure reached as blood is pumped out of the heart chambers
THRUSH
a fungus infection in the mouth
TRIGLYCERIDES
a form of fat that the body makes from sugar, alcohol, and excess calories
T CELLS
a white blood cell responsible for the body's immunity. T cells can destroy cells infected by viruses, graft cells, and other altered cells
TISSUE TYPING
a blood test (performed prior to transplantation) to evaluate the closeness of tissue match between donor's organ and recipient's HLA antigens.
ULTRASOUND
a probe that uses high-frequency sound waves that pass into the body, are reflected back, to build an image of one's internal organs that is shown on a monitor
a tube that drains urine from the bladder to the outside
URETERS
tubes that drain urine from the kidneys to the bladder
URINARY TRACT INFECTION (UTI)
an infection of one or more parts of the urinary tract
VIRUS
a very small agent (germ) that causes infection
WAITING LIST
after evaluation by the transplant physician, a patient is added to the national waiting list by the transplant center. Lists are specific to both geographic area and organ type: heart, lung, kidney, liver, pancreas, intestine, heart-lung, kidney-pancreas. Each time a donor organ becomes available, the UNOS computer generates a list of potential recipients based on factors that include genetic similarity, organ size, medical urgency and time on the waiting list. Through this process, a "new" list is generated each time an organ becomes available.
WHITE BLOOD CELLS
cells in the blood that fight infection; part of the immune system
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