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Renal Transplant
Patient Education
Prepared by:Menah Sharaf
RN,CNC,RTNU,KFSH&RC
Overview
• The roll of the renal transplant team in the
care of renal patients
• The collaboration between the
multidisciplinary team in order to deliver
holistic care for the renal transplant
patient.
WHY TRANSPLANT IS NECESSARY
• Damage to the kidney can seriously affect the
following:
– Removal of water and waste products from the body
– Production of red blood cells
– Regulation of blood pressure and balance of electrolytes such
as potassium, calcium and phosphorus.
• If the damage is severe enough, transplantation may be
necessary. A transplant provides a patient with a
kidney that can keep up with the demands of a full,
active life.
Criteria for accepting patients for renal
transplantation
• Referral from another institution after
determining that renal transplantation
is the optimal treatment for the patient
• Medical report from the referring
institution
• Referrals from other departments
within our hospital
B-2 ward
Surgical
Nursing
I.C.U
Transplant Operating
Surgeons
Room
Transplant
Nephrologists
Transplant
Coordinators
OBG/YN
DPC
Renal
Transplant
Program
Immunology
Transplant
Nurses
Radiology
Clinical
Pharmacist
Dental
Transplant
Health Educators
ECHO lab
Cardiac cath
Admission
Other
referrals
Nutritionist
Transplant
Social
Workers
Pre-Renal Transplant Education
Pre-Transplant testing and information
regarding the patient's overall health status help
in identifying potential problems before they
occur. They also help in determining whether
transplantation is truly the best option for the
patient. All of the above increase the likelihood
of overall success.
Health Education Assessment for
Renal Transplant Recipient
Work-up starting date;-…./.…/….
1. Personal information:
Patient
male
female
Caregiver
male
female
Age:Age:-
Name ……………………
Relationship ……………………
2. Patient:
3. Vascular Access:
4. Diabetic:
Pre-emptive
Hemodialysis
since……..
Peritoneal
since……..
Perma cath
A. VFistula
Femoral cath
Gore-tex graft
Yes
No
Tenkoff catheter
Insulin self Administration………..
Patient
caregiver
5. Hypertensive:
Yes
No
6. Seizures:
Yes
No
7. Permanent residences:
Riyadh
Out side Riyadh, …………………….
8. Relatives in Riyadh:
Yes
No
9. Social Status:
Single
Married
Divorced
Widow
11. Number of Children:
Daughters
Sons
12. State of employment:
Private
Government
13. Education level:
Illiterate
Primary
High School
College
Arabic
Reads
Writes
English
Reads
Writes
10. Number of pregnancies:
14. Learning abilities:
None
Intermediate
Pre renal transplant workup:
Recipient
• Laboratory investigations including Tissue Typing,
Hematology, Serology/Virology, Chemistry, Urinalysis
• Chest X-Ray
• Abdominal Ultra-Sound
• Electrocardiogram (EKG)
• Vaccinations (if needed)
• PPD Skin Test
• Liver Biopsy (as required)
• Dental clearance
• Mammogram
• OB-GYN clearance (females only)
• Pre-renal transplant evaluation
• Other referrals as needed
Pre renal transplant workup:
Donor
• Laboratory investigations including Tissue
Typing, Hematology, Serology/Virology,
Chemistry
• Chest X-Ray
• CT Scan abdomen angiogram
• Electrocardiogram (EKG)
• Vaccinations (if needed)
• PPD Skin Test
• Mammogram
• OB-GYN clearance (females only)
• Pre-renal transplant evaluation
Renal transplant committee meeting
• Recipients and potential donors will be presented
at the Renal Transplant committee
• Members of the Committee
Transplant
Surgeons
HLA
Immunologist
Social worker
Transplant
Coordinator
Transplant
Nephrologist
Clinical
Pharmacist
Transplant
Nurses
Health
Educator
• Final acceptance of both recipients and
donors will be made during the committee
meeting . Any pending issues will be
resolved prior to renal transplant surgery
Day of Admission
1. Transplant pair admitted to the renal ward.
2. Transplant pair to be assessed by surgeon
3. Pre and post-operative education begins
4. Continuation of health education
commenced during pre-renal work-up
The Role of the Health Educator in PreOperative Teaching
• Identify the urinary system location &
function.
• Understanding renal transplant surgery.
• Explains the need for pre-operative
preparation.
• Understanding the importance of
Immunosuppressive therapy & antibiotics.
• Understanding post operative
expectations.
Post Operative Instructions
• Understanding the life long commitment
of immunosuppressive medication.
• Correctly identifying medications
{FK,Pred,…..}
• Understanding the correct time to take
medications
Cont
• Understanding most common side effects.
• Proper storage of medications
• Appropriate hand hygiene
Discharge Instructions
• Reinforcing Post Operative Teaching.
• Importance of bringing all medications to all
clinic visits.
• Dietary Instructions.
• Exercise .
• Hygiene Concerns.
• Social Concerns.
• Recreation/Work precautions.
• Religious duties.
• Sexual activity.
Health Care After You Leave The Hospital
a) Monitor urine output daily.
b) Avoid stopping or changing any medications
without consulting a renal transplant physician .
c) Report any signs & symptoms of rejection or
infection to renal transplant physician.
d) Increase fluid intake.
Post renal transplant follow up
• Donors will follow–up in the transplant surgical
clinic
• Recipients will alternate follow–up in both the
surgical and the post renal transplant clinic twice
weekly with labs for the 1st three months
• Months 4 – 6 post transplant, patients will follow–up
in the post renal transplant clinic every other week
Long term follow up
• After the 7th month post transplant,
patients will be referred back to the
original nephrologist and/or maintain
follow-up in our renal transplant clinic
as deemed necessary by our transplant
physicians.
References
• Gabriel M. Danovitch. (2005). Handbook of Kidney
Transplantation (4th ed.). Lippincott Williams &
Wilkins.
• American Society of Transplantation: Screening of
donor and recipient prior to solid organ
transplantation, (2004) American Journal of
Transplantation. 4(Suppl 10) (p. 10-20). Blackwell
Munksgaard.
• American Society of Transplantation: Guidelines for
vaccination of solid organ transplant candidates and
recipients, (2004), American Journal of
Transplantation. 4(Suppl 10) (p. 160-163). Blackwell
Munksgaard.