Kidney transplantaion 2

Kidney Transplantation

Seragaldin M.Seragaldin M.School of Nursing, University of School of Nursing, University of Raparin. 9.5.2015Raparin. 9.5.20151

Objects Definition Source of kidney donnerCriteria of DonnerCriteria of RecipientNursing care for patient having

Kidney Transplantation Rejection of Kidney TransplantationComplications of the RejectionInterventions for the patient and family

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Definition A kidney transplant is a procedure in which a donor healthy kidney is placed in the abdomen of a patient with chronic renal failure.

Donner: The person who give his/her kidney in order to save the patient life who suffering from end stage renal disease.

Recipient: The person receive transplant kidney from the donner due to end stage renal disease.

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Source of kidney donnerRelated donnder;o Sibling o Identical twino Natural parents

• Non Related donnder

Cadaveric donner

Note: The related donner more possible physiologically. Because he/she has the same

body tissue structure. While psychologically it is impossible. Because the recipient discomfort due to prauding of donner.

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Criteria of Donner• Age is not criteria

• The donner should be free from systemic disease such as hypertension(HTN) or diabetes mellitus (MD)

• Free from infections such as: Tuberculosis (TB) or Urinary Tract Infection (UTI)

• Free from malignancy

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Criteria of Recipient Age of recipient is between 5 to 55 years

The recipient should be free from systemic disease such as hypertension(HTN) or diabetes mellitus (MD)

Free from malignancy

Free from infections

The recipient must have irreversible kidney damage

Inability of the patient to adjust to the hemodialysis 6

Criteria of brain death

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• Apnea

• Deep coma

• Hypothermia

• Absents of cephalic reflex

• Fully dilated and fixed pupil

Nursing care for patient having Kidney Transplantation

Pre operative careAssess knowledge and feelings about the procedure

Continue dialysis as ordered and prevent uremia prior to surgery

Administer immunosuppressive drugs as ordered before surgery to prevent immediate graft rejection

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Nursing care for patient having Kidney Transplantation

Post operative careMaintain urinary catheter patency and a closed system

Measure urine output every 30 to 60 minutes initially to determine fluid balance and transplant function

Monitor serum electrolytes and renal function tests to monitor graft function and fluid and electrolyte status

Monitor for possible complications such as hemorrhage or Renal artery thrombosis 9

Nursing care for patient having Kidney Transplantation

Post operative care

Daily checking of blood test to determined renal function

Daily weighting the patient and monitor for depression

Check the signs and symptoms of infection or rejection

Check the dressing to determine internal and external bleeding

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Rejection of Kidney Transplantation

Is failure of the new kidney in the recipient’s body that have three types as bellow 1.Hyper acute rejection (occur during 48 hours after the operation)2. Acute rejection (occur within 1 to 6 weeks from transplant)3. Chronic rejection (occur from 3 months to longer after transplant

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Sings and symptoms of Kidney Transplantation Rejection

Fever Oliguria TendernessHypertensionIncrease of blood creatinine

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Complications of the Rejection

Gastro intestinal hemorrhageCardio Vascular DiseaseHypovolemia (shock)DepressionGastric ulcer

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Interventions for the patient and family

Patients (pt) should contact to his/her doctor about any complication and vised the clinic for; physical examination, and lab tests

Identify each medication such as name, color, size, and doseAvoid weight gain, because it need to increase dose of

immunosuppressive drug which lead to decrease the immunity of the pt

Pt should be learn sings and symptoms of the infection and rejection

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References Linda S. Williams and Paula D. Hopper. (2003).

Understanding Medical Surgical Nursing (2nd ed.). Philadelphia: PA 19103.

Sylvia S. Mader. (2004). Understanding Human Anatomy and Physiology (5th ed.). New York: McGraw-Hill.

Amy M. (2011). Focus on Nursing Pharmacology (5th ed.). New York: McGraw-Hill.

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