Kidney Transplant

WHAT YOU SHOULD KNOW:

• Kidney transplant is surgery to replace a damaged kidney with a new kidney from a donor (another person). The kidneys are two bean-shaped organs found under the ribs on each side of the upper abdomen (stomach). The kidneys remove wastes and other unwanted chemicals from the body. These wastes are flushed from the body as urine. When the kidneys are badly damaged, these wastes build-up in the body and cause harm. This may cause seizures (convulsions), trouble breathing, increased blood pressure, body swelling, confusion, fainting, or even death. A new kidney may be needed to replace the damaged kidney to keep the body working.
  
  
• The new kidney may come from family members, spouse, close friends, or even someone you do not know. In most cases, surgery is done at the same time between you and your donor. An incision (cut) will be made on your abdomen and your new kidney will be placed. The blood vessels will be connected and the ureter will be attached to your bladder. The ureter is the narrow tube that connects the kidney to the bladder where urine is temporarily stored. Your new kidney should begin to work as soon as blood flows through it. With a kidney transplant, you may resume your usual activities and prevent more serious health problems.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

There are always risks with surgery. You may bleed more than the usual, get an infection, have trouble breathing, or get blood clots. Nerves, blood vessels, muscles, intestines, and other organs may get damaged. You may have problems with your ureter or bladder which may cause urine to leak out. Your body may also reject the new kidney from your donor. There is also a risk that your condition may worsen or you may die during surgery. You will need dialysis for the rest of your life if you do not have a kidney transplant. Ask your caregiver if you have questions about your surgery, condition, medicines, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.
  
  
• Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty its contents.
  
  
• Tubes:
  
  
  • IV: An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.
    
    
  • Central line: A central line is an IV catheter or tube. It is put into a large blood vessel near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. The central line may be used to give medicines or IV fluids. It may also be hooked up to a monitor to take pressure readings. This information helps caregivers to check how well your heart is working.
  
  
• Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.
  
  
• General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.
  
  
• Monitoring:
  
  
  • Heart monitor: This is also called an ECG. Sticky pads are placed on different parts of your body. Each pad has a wire that is hooked to a TV-type screen. This shows caregivers a tracing of the electrical activity of your heart.
    
    
  • Pulse oximeter: A pulse oximeter is a machine that tells how much oxygen is in your blood. A cord with a clip or sticky strip is placed on your ear, finger, or toe. The other end of the cord is hooked to a machine. Caregivers use this machine to see if you need more oxygen.
    
    
  • Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

During your surgery: Your skin is cleaned and then covered with clean sheets. Your caregiver will make an incision on your abdomen. The new kidney will be sewed in place by connecting its blood vessels to your own blood vessels. The ureter of the new kidney will be attached to your bladder. Your damaged kidneys will be left in place unless they are causing problems such as infection or high blood pressure. Thin rubber tubes will be put near the kidney to drain blood from your incisions. Your incisions will be closed with stitches (threads) or surgical tape and covered with bandages.

After your surgery:

• You may be taken to a recovery room or an intensive care unit (ICU) until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is OK. When caregivers see that you are OK, you will be taken back to your hospital room. The bandages used to cover your stitches keep the area clean and dry to prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound or drains. The drains are taken out when the incision stops draining. Ask your caregiver for more information about ways to prevent bleeding and take care of your incision.
  
  
• Activity: Caregivers may help you get out of bed to walk on the same day of surgery, or the day after. Ask caregivers if there are exercises that you may do while in bed. Exercise helps blood move through your body and may help prevent blood clots from forming. Your caregiver will tell you when it is OK to get out of bed. Call your caregiver before getting up for the first time. If you feel weak or dizzy while standing up, sit or lie down right away and call your caregiver.
  
  
• Deep breathing and coughing: This breathing exercise helps to keep you from getting a lung infection after surgery. Deep breathing opens the tubes going to your lungs. Coughing helps to bring up sputum (mucus) from your lungs for you to spit out. You should deep breathe and cough every hour while you are awake even if you wake up during the night.
  
  
  • Hold a pillow tightly against your incision (cut) when you cough to help decrease the pain. Take a deep breath and hold the breath as long as you can. Then push the air out of your lungs with a deep, strong cough. Put any sputum that you have coughed up into a tissue. Take 10 deep breaths in a row every hour while awake. Remember to follow each deep breath with a cough.
    
    
  • You may be asked to use an incentive spirometer. This helps you take deeper breaths. Put the plastic piece into your mouth and take a very deep breath. Hold your breath as long as you can. Then let out your breath. Use your incentive spirometer 10 times in a row every hour while awake.
  
  
• Diet: You may be able to eat when bowel sounds are heard. Your caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be given ice chips at first, and then liquids such as water, broth, juice, or soda pop. If you do not have problems after drinking liquids, caregivers may then give you soft foods. Some examples of soft foods are ice cream, applesauce, or custard. Once you can eat soft food easily, you may begin eating your usual diet.
  
  
• Foley catheter: A Foley catheter is a tube that is put into your bladder to drain your urine into a bag. The bladder is an organ where urine is kept. Keep the bag of urine well below your waist. Lifting the urine bag higher will make the urine flow back into your bladder, which can cause an infection. Avoid pulling on the catheter because this may cause pain and bleeding, and the catheter may come out. Do not allow the catheter tubing to kink because this will block the flow of urine.
  
  
• Medicines: Your caregiver may give you the following kinds of medicines:
  
  
  • Antibiotics: Antibiotics may be given to help treat or prevent an infection caused by germs called bacteria.
    
    
  • Antinausea medicine: This medicine may be given to calm your stomach and control vomiting (throwing up). Pain medicine may upset your stomach and make you feel like vomiting. Because of this, pain medicine and anti-nausea medicine are often given at the same time.
    
    
  • Antirejection medicine: Your body tries to attack your new organ like it would attack an infection. These medicines are given to help your body accept your new organ and to keep your body from rejecting it. You may need to take this medicine for the rest of your life.
    
    
  • Erythropoietin: You may need erythropoietin to prevent anemia (low red blood cell count). Erythropoietin is a natural chemical that helps your body make red blood cells.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Medicine may be given regularly, or may only be given if you ask caregivers for it. Tell caregivers if your pain does not decrease enough for you to feel better. Do not wait to ask for your pain medicine until the pain is very bad. The medicine may not work as well at controlling your pain if you wait too long to take it. Ask your caregiver for help getting out of bed if you feel tired or dizzy.
    
    
  • Vitamins and minerals: Vitamins and minerals, especially vitamin D, calcium or iron, may be needed to improve your health.
    
    
  • Others: If you have other conditions or diseases, you may also need medicines to treat them. These may include blood pressure or heart medicines, insulin, or diabetic pills. You may also continue being treated with chemotherapy or radiation therapy if you have cancer. Your caregiver may suggest other medicines to help control other signs and symptoms that may be present.
  
  
• Tests and monitoring: Caregivers will take your vital signs frequently for several hours. The pulses on your legs and feet will also be checked often. This may help the caregiver know if you have any problems with blood flow after your surgery.
  
  
  • Blood and urine tests: Samples of your blood and urine are sent to a lab for tests. These tests check how well your new kidney is working.
    
    
  • Imaging tests: Angiography, ultrasound, and other imaging tests may be done to check blood flow in your urinary tract.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Link to Page

Print Page

Email Page