Lesson 1Infectious disease evaluation: latent infections (TB, CMV, EBV, VZV, HBV, HCV, HIV), vaccination review, prophylaxis planningThis lesson details infection checks for transplant patients, focusing on hidden infections common in Zambia like TB, vaccination status, and custom prevention plans to cut down post-transplant infections under immune suppression.
Screening for TB, CMV, EBV, and VZVHBV, HCV, and HIV testing and stagingPre‑transplant vaccination catch‑up planDonor‑recipient serostatus risk matchingDesigning antiviral and PCP prophylaxisLesson 2Cardiology workup: noninvasive ischemia testing, coronary angiography indications, functional capacity assessment, perioperative revascularization criteriaThis covers heart checks for transplant candidates, including non-invasive tests for blocked arteries, when to do heart scans, fitness evaluation, and criteria for fixing blockages to lower heart risks during surgery.
Baseline ECG and echocardiographyStress testing and ischemia detectionIndications for coronary angiographyFunctional capacity and METs assessmentRevascularization versus medical therapyLesson 3Endocrine and metabolic optimization: diabetes control strategies pre-transplant, obesity and nutritional optimization, weight-loss options and timelineThis reviews hormone and metabolism issues before kidney transplant, stressing diabetes management, weight and diet improvement, loss strategies, and practical timelines to hit targets that reduce surgery and long-term issues.
Pre‑transplant HbA1c and glycemic targetsAdjusting insulin and non‑insulin therapiesObesity‑related surgical and graft risksNutritional assessment and protein‑energy statusPharmacologic and surgical weight‑loss optionsLesson 4Laboratory and imaging baseline tests: crossmatch/serology, HLA typing, PRA, baseline renal ultrasound and vascular imaging, baseline BK/JC viral statusThis outlines key lab and scan tests setting the pre-transplant baseline, like tissue matching, antibody levels, blood tests, kidney scans, vessel imaging, and virus checks to guide donor choice and surgery plans.
ABO typing, HLA typing, and PRA levelsComplement‑dependent and flow crossmatchBaseline renal ultrasound and DopplerCT or MR angiography of iliac vesselsBK and JC virus PCR and serologic statusLesson 5Decision criteria to accept or delay transplant: cardiopulmonary thresholds, infection control, vascular access/target vessel suitability, BMI and metabolic targetsThis explains how teams decide to go ahead or wait on kidney transplant, weighing heart-lung limits, infection control, vessel fitness, and weight-metabolism goals to match urgency with fixable risks.
Cardiopulmonary fitness and VO2 thresholdsActive infection and sepsis exclusionTarget vessel imaging and suitabilityBMI cutoffs and weight‑loss milestonesMetabolic syndrome and blood pressure goalsLesson 6Pulmonary evaluation and anesthesia risk: spirometry, sleep apnea screening, frailty and functional status assessmentThis describes lung and anaesthesia risk checks, covering breathing tests, sleep apnoea screens, weakness, and daily function to gauge surgery risks and plan improvements, monitoring, and recovery.
History, exam, and spirometry indicationsChest imaging and pulmonary hypertensionScreening and management of sleep apneaFrailty indices and gait speed testingAnesthesia risk classification and planningLesson 7Vascular surgery assessment: peripheral arterial disease mapping, iliac/femoral vessel duplex/CT angiography, access site planningThis explores vessel surgery checks for kidney transplant, mapping leg artery issues, scanning hip and thigh vessels, and picking best entry points for safe joins and lasting blood flow.
Clinical exam for peripheral arterial diseaseDuplex ultrasound of iliac and femoral vesselsCT angiography for complex vasculatureChoosing side and site for graft anastomosisManaging severe aortoiliac occlusive diseaseLesson 8Hematology and coagulation: platelet function, anticoagulation/antiplatelet management, transfusion thresholdsThis focuses on blood and clotting checks, covering low blood counts, platelet work, blood thinner handling, to set transfusion limits and cut bleeding or clotting around surgery.
Baseline CBC, iron studies, and anemia planPlatelet count, function, and uremic bleedingWarfarin, DOAC, and heparin bridgingAntiplatelet interruption and continuationRed cell and platelet transfusion thresholdsLesson 9Psychosocial and adherence assessment: evaluation of social support, substance use, medication adherence predictorsThis covers structured social and adherence checks before transplant, including family support, mental health, substance use, and medicine-taking predictors to spot barriers and plan fixes for better graft life.
Standardized psychosocial screening toolsEvaluating caregiver and social supportScreening for depression and anxietySubstance use history and toxicology testsPredictors and remediation of nonadherenceLesson 10Comprehensive medical history and physical exam: diabetes, cardiovascular, peripheral vascular disease, dialysis access reviewThis sums up full pre-transplant history and exam structure, stressing heart, leg vessels, diabetes, and dialysis line review to find no-gos and fixable surgery risks.
Structured transplant‑focused historyCardiovascular and peripheral vascular reviewDiabetes complications and foot examinationDialysis access function and infection historyMedication reconciliation and allergy review
