INTRODUCTION Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end stage renal disease (ESRD)
CLASSIFICATION• DESEASED DONOR (CADAVERIC)• LIVING DONOR1. GENETICALLY RELATED LIVING RELATED)2. NON RELATED (LIVING UNRELATED)
INDICATION ESRD GFR less than 15ml/L MALIGNANCY HYPERTENSION DIABETES MELLITUS GENETIC DISEASES- polycystic kidney diseases METABOLIC DISORDERS AUTO IMMUNE CONDITIONS- lupus ,good pastures syndrome CRF
CONTRAINDICATIONS CARDIAC ANDPULMONARY INSUFFICIENCY HEPATIC DISEASES CONCURRENT TOBACCO USE AND MORBID OBESITY PUTS THE PATIENT AT RISK FOR SURGERY. SUBSTANCE ABUSE HIV
LIVING DONORS EVALUATE DONORS ON PHYSICAL,MEDICAL AND PSYCHOLOGICAL GROUNDS. ASSURE THE PATIENT THAT THERE WILL BE NO LONG TERM HARM TO DONOR. IN SOME CASES MALE LIVING DONOR MAY DEVELOP A HYDROCELE ON THE SCROTUM ON THE SIDE OF NEPHRECTOMY. LIVE DONOR PROCEDURE ARE MOSTLY LAPROSCOPIC,HENCE LESS PAINFULL,LESS SCARRING AND FASTER RECOVERY.
DESEASED DONORS BRAIN DEAD (BD) DONORS DONATION AFTER CARDIAC DEATH BRAIN DEAD OR “ BEATING HEART” donors are considered dead but the pumping heart continues to perfuse the other organs. DONATION AFTER CARDIAC DEATH are elective donation of organ by patient himself or the relatives to withdraw life support as they have slim chances of survival.
COMPATIBILITY THE PATIENT HAS TO BE ABO COMPATIBLE THE RECEPIENT SHOULD SHARE AS MANY AS HLA ANTIGENS AND MINOR ANTIGENS AS POSSIBLE. IMMUNOSUPRESSENT DRUGS ARE GIVEN TO PREVENT ANTI BODY REACTIONS PERFORM ANTI BODY TEST ON POTENTIAL RECEPIENT.
POST OPERATION TIME- 3 HRS APPROX DONOR KIDNEY WILL BE PLACED IN THE LOWER ABDOMEN ARTERIES,VIENS FROM THE RECIPIENTS BODY IS CONNECTED TO NEW KIDNEY FINAL STEP IIS TO CONNECT THE URETER TO NEW KIDNEY NEW KIDNEY STARTS FUNCTIONING IMMEDIATELY, LIVING KIDNEY TAKE 3-5DAYS AND CADEVERIC KIDNEY TAKE UPTO 7- 15DAYS
Contd.. DIURETICS AND IMMUNOSUPRESSANTS ARE ADMINISTERED FOR EFFECTIVE FUNCTIONING OF NEW KIDNEY. MONTIOR KFT,CBC. BIOPSY.
POST OPERATIVE DIET AVOID GRAPES POMEGRANATE AND GREEN TEA PRODUCTS MONITOR FOR KIDNEY REJECTION.
COMPLICATION TRANSPLANT RREJECTION INFECTION AND SEPSIS POST TRANSPLANT LYMPH PROLIFERATIVE DISORDER ELECTROLYTE IMBALANCES IATRAGENIC SIDE EFFECTS
PROGNOSIS KIDNEY TRANSPLANTATION IS A LIFEEXTENDING PROCEDURE.A PATIENT MAYLIVE UPTO 15YRS LONGER WITH A KIDNEYTRANSPLANT THAN IF KEPT ON A DIALYSIS. PATIENTS WILL HAVE MORE ENERGY,A LESRESTRICTED DIET,AND FEWERCOMPLICATIONS WITH A KIDNEYTRANSPLANT.
BIBLIOGRAPHY Phipps medical and surgical nursing health and illness perspective. Brunner and suddarth’s textbook of medical and surgical nursing Google .com