Complications as we know with any type of transplant can be rejection, also acute tubular necrosis can occur. This is related to ischemia, the recipient will likely need dialysis until the BUN and creatinine levels actually have an opportunity to normalize because of the ischemia that occurs, so we need to help perfuse. So really going to closely monitor their I&O status where normally we say we wouldn’t give most of your renal clients, you don’t treat with volume resuscitation, but in this instance, we are trying to encourage the new kidney to make urine. Definitely the plan of care is going to be different to focus on that. Other postoperative considerations, we talked about thrombosis in the renal vessels that can occu; may require renal or surgical repair. This could include ballooning or stinting of renal arteries. It’s going to be dependent upon the degree of ischemia that occurs. Immunosuppressive drug therapy is lifelong therapy. And the psychosocial preparation; it’s very important for the clients to understand that transplant definitely is not a quick fix, there still again is that word “regimen” to follow after the surgery. Depression and fatigue may be things that set it, and that kidney, there still is the opportunity the new transplanted kidney to fail, so very important for clients to know that up front.
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- Winter '16
- Nephrology, Chronic kidney disease