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 2 bean-shaped organs found under the ribs on each side of the upper abdomen. The kidneys remove wastes and other unwanted chemicals from your body. The body disposes of these wastes in your urine.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed more than expected or get an infection after surgery. 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. You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Your condition may get worse during surgery, and may become life-threatening. Your body may reject the new kidney.

  • Without a kidney transplant, you will need dialysis for the rest of your life.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Enema: You may need an enema before your surgery. This is liquid put into your rectum to help empty your bowel.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • 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 central line may be used to give medicines or IV fluids. It may also be hooked up to a monitor to take certain blood pressure readings. This information helps caregivers 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 will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

During your surgery:

Your skin will be cleaned and then covered with clean sheets. Your caregiver will make an incision on your abdomen. He will attach your new kidney by stitching the blood vessels of the new kidney to your 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 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 to make sure you are okay. Do not get out of bed until your caregiver says it is okay. When caregivers see that you are okay, you will be taken back to your hospital room. A caregiver may remove the bandages soon after surgery to check your wound or drains. The drains are taken out when the incision stops draining.

  • Activity: You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

    • Antirejection medicine: This helps prevent your body from rejecting your new kidney. You may need to take this medicine for the rest of your life.

    • Erythropoietin: This is given to prevent anemia and help your body make red blood cells.

    • Pain medicine: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

    • Vitamins and minerals: Vitamins and minerals, especially vitamin D, calcium, or iron, may be needed to improve your health.

  • Tests and monitoring: Caregivers will take your vital signs often for several hours. The pulses on your legs and feet will also be checked often. This helps 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 kidneys and urinary tract.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

Learn more about Kidney Transplant (Inpatient Care)

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