Open Live Donor Nephrectomy

WHAT YOU SHOULD KNOW:

• Open live donor nephrectomy (ne-FREK-to-me) is surgery to remove a kidney. The kidney is then placed in another person who has kidney disease or damage. A person who donates (gives) a kidney is called a donor. The person who receives the kidney is called a recipient. The kidneys are two bean-shaped organs found under the ribs on each side of the upper abdomen. The kidneys remove wastes and other unwanted chemicals from the body. These wastes are flushed out of the body in urine. When kidneys are badly damaged, these wastes build up in a person's body. The waste build-up causes symptoms such as dizziness, headaches, seizures, confusion, fainting, and may even lead to death.
  
  
• To be a kidney donor, you must be in good health, and between 18 and 70 years old. To be a donor, you must know and understand what can happen to you. You must also have thought carefully about giving your kidney to someone else. Your kidney can replace the damaged kidney, and help the recipients body to get rid of wastes as it should. Being a kidney donor may help the person who is the kidney recipient live longer.

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:

Risks with surgery include infection, bleeding, and trouble breathing. Nerves, blood vessels, muscles, intestines, and other organs may be damaged. Your ureter (tube for urine) may be damaged and cause urine to leak out into your body. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening. Call your caregiver if you are worried or have questions about your condition, treatment, or care.

WHILE YOU ARE HERE:

Before your surgery:

• Informed consent: Giving a kidney is a serious decision, and you must think about it very carefully. No one should force or pressure you to give your kidney. You must be giving it willingly. Your caregiver will tell you what will happen before, during, and after surgery in words that you know. You will be told what tests, treatments, or procedures may need to be done. Your caregiver will tell you the risks of having this surgery. He will also tell you how your kidney can help someone else. If you have consented (agreed) to giving your kidney, you have the right to change your mind. Before giving your consent, make sure all your questions have been answered and that you understand what may happen.
  
  
• Tests:
  
  
  • Computerized tomography scan: This is also called a CT scan. An x-ray machine uses a computer to take pictures of your abdomen. It may be used to look for changes and problems with your kidneys.
    
    
  • Magnetic resonance imaging: This is also called an MRI. During the MRI, pictures of your kidney and abdomen are taken. An MRI may be used to check around your kidneys for problems.
    
    
  • Renal arteriography: Renal arteriography is done to check for problems with blood vessels in your kidneys. Your caregiver uses a special dye to help blood vessels show up better on x-ray pictures. Tell your caregiver if you are allergic to iodine or shellfish (lobster, crab), as you may also be allergic to the dye used for this test.
  
  
• Enema: You may need to have an enema before your surgery. This is liquid put into your rectum to help empty your bowels.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Monitoring:
  
  
  • 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.
  
  
• 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: Caregivers use this medicine to keep you asleep and free from pain during surgery. They give you anesthesia through your IV or as a gas. You may breathe in the gas through a mask or through a breathing tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

You are turned to your side after you are asleep. Your skin is cleaned and then covered with clean sheets. Your caregiver makes an incision (cut) on your side. The tip of your lowest rib may need to be cut to let your caregiver see and reach your kidney. Blood vessels and tissues are clamped, tied, or cut, and your kidney is removed. Your caregiver checks for problems before closing the incision with stitches and covering it with a bandage.

After your surgery:

You will be taken to a recovery room until you are fully awake. Caregivers will watch you closely for any problems. 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 help prevent infection. A caregiver may remove the bandages soon after your surgery to check your wound.

• 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.
  
  
• Food and drink after surgery: You will 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 food easily, you may slowly begin to eat solid foods.
  
  
• Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.
  
  
• Medicines: You may be given the following 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.
    
    
  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.
    
    
  • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

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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 Open Live Donor Nephrectomy (Inpatient Care)